Stairway-related injuries in children

To identify the pattern and severity of injury associated with stairway-related falls in children.

During a 2-year period, all children less than 5 years of age presenting to the University of Virginia Pediatric Emergency Department with a stairway-related injury were prospectively studied. At the time of the emergency department visit, demographic and epidemiologic information was obtained. Injuries were assigned E codes and N codes. A Modified Injury Severity Scale (MISS) score was calculated for each child. Excluded from the study were children with suspected intentional trauma and children with walker-related stairway injuries.

Sixty-nine children were enrolled in the study. The median age was 2 years. Head and neck injuries occurred in 90% of the patients, extremity injuries in 6%, and truncal injuries in 4%. Injury to more than one body region did not occur. The majority of injuries were minor. Ninety-six percent had a total MISS score < or = 2. Fifteen patients (22%) suffered significant injuries, including concussion in 11 (16%), skull fracture in 5 (7%), cerebral contusion in 2 (3%), subdural hematoma in 1 (1%), and a C-2 fracture in 1 (1%).

The majority of stairway-related injuries are minor. Injuries to the head and neck region predominate. Injuries to multiple body regions are rare. However, significant stairway-related injuries may be more common than previously reported.