Stair-Related Injuries to Young Children Treated in US Emergency Departments, 1999–2008

Zielinski, A; Rochette, Lynne M.; Smith, Gary A.

doi:10.1542/peds.2011-2314

Cited by 31 publications

(21 citation statements)

References 21 publications

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“…Child caregivers using a carrier should minimize the use of stairs and refrain from carrying other objects while on the stairs, using the free hand to grasp the handrail. 35 Infants should be matched to carriers that are appropriate for their size and weight. 36 Nearly one-third of product failures were associated with baby carriers, which included instances of handle detachment and product collapse.…”

Section: Discussionmentioning

confidence: 99%

Nursery Product-Related Injuries Treated in United States Emergency Departments

2017

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OBJECTIVE: The goal of this study was to determine the epidemiology of injuries associated with nursery products among young children treated in US emergency departments. METHODS:Data from the National Electronic Injury Surveillance System were retrospectively analyzed for patients aged <3 years who sustained an injury associated with a nursery product from 1991 through 2011. RESULTS:An estimated 1 391 844 (95% confidence interval, 1 169 489-1 614 199) nursery product-related injuries among children aged <3 years were treated in US emergency departments during the 21-year study period, averaging 56.29 injuries per 10 000 children. The annual injury rate decreased significantly by 33.9% from 1991 to 2003, followed by a significant increase of 23.7% from 2003 to 2011. The decrease was driven by a significant decline in baby walker/jumper/exerciser-related injuries; the increase was driven by a significant increase in concussions and closed head injuries. Nursery product-related injuries were most commonly associated with baby carriers (19.5%), cribs/mattresses (18.6%), strollers/carriages (16.5%), or baby walkers/jumpers/exercisers (16.2%). The most common mechanism of injury was a self-precipitated fall (80.0%), and the most frequently injured body region was the head or neck (47.1%). CONCLUSIONS:Although successful injury prevention efforts with baby walkers led to a decline in nursery product-related injuries from 1991 to 2003, the number and rate of these injuries have been increasing since 2003. Greater efforts are warranted to prevent injuries associated with other nursery products, especially baby carriers, cribs, and strollers. Prevention of falls and concussions/closed head injuries associated with nursery products also deserves special attention.

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Section: Discussionmentioning

confidence: 99%

Nursery Product-Related Injuries Treated in United States Emergency Departments

2017

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“…Prior studies on pediatric falls have evaluated specific mechanisms of falls (windows, stairs, furniture) (Harris et al, 2011; Pressley & Barlow, 2005; Zielinski et al, 2012; Pomerantz et al, 2012; Kendrick et al, 2015; Kendrick et al, 2016) or specific injuries sustained (head injury) (Love et al, 2009; Ibrahim et al, 2012). Few population-based studies have examined overall risk factors and injury mechanisms for falls as a function of age (Khambalia et al, 2006; Pitone & Attia, 2006; Unni et al, 2012; Wang et al, 2013).…”

Section: Introductionmentioning

confidence: 99%

Pediatric falls ages 0–4: understanding demographics, mechanisms, and injury severities

et al. 2018

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BackgroundPediatric unintentional falls are the leading cause of injury-related emergency visits for children < 5 years old. The purpose of this study was to identify population characteristics, injury mechanisms, and injury severities and patterns among children < 5 years to better inform age-appropriate falls prevention strategies.MethodsThis retrospective database study used trauma registry data from the lead pediatric trauma system in Georgia. Data were analyzed for all patients < 5 years with an international classification of disease, 9th revision, clinical modification (ICD-9 CM) external cause of injury code (E-code) for unintentional falls between 1/1/2013 and 12/31/2015. Age (months) was compared across categories of demographic variables, injury mechanisms, and emergency department (ED) disposition using Kruskal-Wallis ANOVA and the Mann Whitney U test. The relationships between demographic variables, mechanism of injury (MOI), and Injury Severity Score (ISS) were evaluated using multinomial logistic regression.ResultsInclusion criteria were met by 1086 patients (median age = 28 months; 59.7% male; 53.8% White; 49.1% < 1 m fall height). Younger children, < 1-year-old, primarily fell from caregiver’s arms, bed, or furniture, while older children sustained more falls from furniture and playgrounds. Children who fell from playground equipment were older (median = 49 months, p < 0.01) than those who fell from the bed (median = 10 months), stairs (median = 18 months), or furniture (median = 19 months). Children < 1 year had the highest proportion of head injuries including skull fracture (63.1%) and intracranial hemorrhage (65.5%), 2-year-old children had the highest proportion of femur fractures (32.9%), and 4-year-old children had the highest proportion of humerus fractures (41.0%). Medicaid patients were younger (median = 24.5 months, p < 0.01) than private payer (median = 34 months). Black patients were younger (median = 20.5 months, p < 0.001) than White patients (median = 29 months). Results from multinomial logistic regression models suggest that as age increases, odds of a severe ISS (16–25) decreased (OR = 0.95, CI = 0.93–0.97).ConclusionsPediatric unintentional falls are a significant burden of injury for children < 5 years. Future work will use these risk and injury profiles to inform current safety recommendations and develop evidence-based interventions for parents/caregivers and pediatric providers.Electronic supplementary materialThe online version of this article (10.1186/s40621-018-0147-x) contains supplementary material, which is available to authorized users.

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“…While stair/step related injuries comprised the largest proportion of overall product injury costs,2 their contribution decreased substantially for the <1 year age group compared with 1995–1996, when stairs and steps were the leading contributor at 15% of total product injury costs for this age group. In 2009–2010, stairs and steps were the fourth leading cause among children under 1 year of age, at 6% of total injury costs.…”

Section: Resultsmentioning

confidence: 95%

“…While much progress has been made in preventing stair related injuries among children,2 stairs still contributed substantially to injury costs among those over age 19 years. Thus intervention to prevent stair related injuries should continue to be a priority.…”

Section: Discussionmentioning

confidence: 99%