Love Pamela F, Tepas Joseph J, Wludyka Peter S, Masnita-Iusan Carmen
Department of Pediatric Emergency Medicine, University of Florida College of Medicine/Jacksonville, Jacksonville, Florida 32209, USA.
J Trauma. 2009 Jul;67(1 Suppl):S12-5. doi: 10.1097/TA.0b013e3181ac7f22.
Falls remain a major cause of childhood morbidity and mortality. To improve effectiveness of our prevention program, we used our electronic injury surveillance database to analyze patient variables and the incidence of fall-related brain injury.
The database was queried for all injuries treated in the pediatric emergency department for which the word "fall" was listed as part of the chief complaint. Age, sex, and mechanism variables were cross tabulated for analysis with traumatic brain injury (TBI) codes.
Between June 2005 and June 2008, the electronic surveillance system reported 39,718 injury-related visits to the pediatric emergency department. Falls were reported in 3,436 patients (2,107 males, 1,329 females). TBI occurred from falls in 171 patients. Although black children had a higher fall rate (69.24%) than white children (23.75%) and non-black, non-white children (7.01%), white children had the highest TBI rate from falls (9.47%). TBI from falls occurred at a lower mean age for females (5.40 +/- 4.45) than males (6.6 +/- 5.15) and for non-whites (5.98 +/- 4.88) than whites (6.21 +/- 4.93). Multiple logistic regression demonstrated a significant influence of age, race, and sex on the likelihood that a fall results in TBI. Females have a higher risk of TBI from falls than males from ages 0 to 11.5. This runs contrary to previous studies suggesting that toddler males are at highest risk for TBI.
A disproportionate number of infants, toddlers, and adolescents sustain brain injury from falls. Race and sex group differences mandate enhanced focus on environmental safety and risk-taking behaviors.
跌倒仍然是儿童发病和死亡的主要原因。为提高我们预防计划的有效性，我们利用电子伤害监测数据库分析患者变量以及跌倒相关脑损伤的发生率。
查询该数据库中所有在儿科急诊科治疗的损伤病例，这些病例的主诉中包含“跌倒”一词。对年龄、性别和受伤机制变量与创伤性脑损伤（TBI）编码进行交叉列表分析。
在2005年6月至2008年6月期间，电子监测系统报告了39718例与损伤相关的儿科急诊科就诊病例。3436例患者报告有跌倒情况（男性2107例，女性1329例）。171例患者因跌倒发生了TBI。尽管黑人儿童的跌倒率（69.24%）高于白人儿童（23.75%）和非黑人、非白人儿童（7.01%），但白人儿童因跌倒导致TBI的发生率最高（9.47%）。女性因跌倒导致TBI的平均年龄（5.40±4.45岁）低于男性（6.6±5.15岁），非白人（5.98±4.88岁）低于白人（6.21±4.93岁）。多因素逻辑回归分析表明，年龄、种族和性别对跌倒导致TBI的可能性有显著影响。0至11.5岁的女性因跌倒导致TBI的风险高于男性。这与之前表明幼儿期男性TBI风险最高的研究结果相反。
大量婴幼儿和青少年因跌倒而遭受脑损伤。种族和性别群体差异要求我们更加关注环境安全和冒险行为。
