Division of Primary Care, School of Medicine, University of Nottingham, Nottingham, England.
Norfolk and Norwich University Hospitals, National Health Service Foundation Trust, Norwich, England.
JAMA Pediatr. 2015 Feb;169(2):145-53. doi: 10.1001/jamapediatrics.2014.2374.
Falls from furniture are common in young children but there is little evidence on protective factors for these falls.
To estimate associations for risk and protective factors for falls from furniture in children aged 0 to 4 years.
DESIGN, SETTING, AND PARTICIPANTS: Multicenter case-control study at hospitals, minor injury units, and general practices in and around 4 UK study centers. Recruitment commenced June 14, 2010, and ended April 27, 2012. Participants included 672 children with falls from furniture and 2648 control participants matched on age, sex, calendar time, and study center. Thirty-five percent of cases and 33% of control individuals agreed to participate. The mean age was 1.74 years for cases and 1.91 years for control participants. Fifty-four percent of cases and 56% of control participants were male. Exposures included safety practices, safety equipment use, and home hazards.
Falls from furniture occurring at the child's home resulting in attendance at an emergency department, minor injury unit, or hospital admission.
Compared with parents of control participants, parents of cases were significantly more likely not to use safety gates in the home (adjusted odds ratio [AOR], 1.65; 95% CI, 1.29-2.12) and not to have taught their children rules about climbing on kitchen objects (AOR, 1.58; 95% CI, 1.16-2.15). Cases aged 0 to 12 months were significantly more likely to have been left on raised surfaces (AOR, 5.62; 95% CI, 3.62-8.72), had their diapers changed on raised surfaces (AOR, 1.89; 95% CI, 1.24-2.88), and been put in car/bouncing seats on raised surfaces (AOR, 2.05; 95% CI, 1.29-3.27). Cases 3 years and older were significantly more likely to have played or climbed on furniture (AOR, 9.25; 95% CI, 1.22-70.07). Cases were significantly less likely to have played or climbed on garden furniture (AOR, 0.74; 95% CI, 0.56-0.97).
If estimated associations are causal, some falls from furniture may be prevented by incorporating advice into child health contacts, personal child health records, and home safety assessments about use of safety gates; not leaving children, changing diapers, or putting children in car/bouncing seats on raised surfaces; allowing children to play or climb on furniture; and teaching children safety rules about climbing on objects.
儿童从家具上坠落很常见,但对于这些坠落的保护因素几乎没有证据。
估计 0 至 4 岁儿童从家具上坠落的风险和保护因素。
设计、地点和参与者:在 4 个英国研究中心的医院、轻伤单位和全科医生中进行多中心病例对照研究。招募于 2010 年 6 月 14 日开始,2012 年 4 月 27 日结束。参与者包括 672 名从家具上坠落的儿童和 2648 名年龄、性别、日历时间和研究中心相匹配的对照参与者。35%的病例和 33%的对照者同意参与。病例的平均年龄为 1.74 岁,对照者为 1.91 岁。54%的病例和 56%的对照者为男性。暴露包括安全措施、安全设备使用和家庭危险。
在儿童家中发生的从家具上坠落事件,导致前往急诊室、轻伤单位或住院。
与对照参与者的父母相比,病例参与者的父母更有可能不在家中使用安全门(调整后的优势比[OR],1.65;95%置信区间[CI],1.29-2.12),并且没有教过孩子有关攀爬厨房物品的规则(OR,1.58;95%CI,1.16-2.15)。0 至 12 个月大的病例更有可能被留在高处(OR,5.62;95%CI,3.62-8.72),在高处更换尿布(OR,1.89;95%CI,1.24-2.88),以及在高处使用汽车/弹跳座椅(OR,2.05;95%CI,1.29-3.27)。3 岁及以上的病例更有可能在家具上玩耍或攀爬(OR,9.25;95%CI,1.22-70.07)。病例更不可能在花园家具上玩耍或攀爬(OR,0.74;95%CI,0.56-0.97)。
如果估计的关联是因果关系,那么通过将有关安全门使用、不在高处放置儿童、更换尿布或放置儿童在汽车/弹跳座椅、允许儿童在家具上玩耍或攀爬以及教授儿童攀爬物品的安全规则的建议纳入儿童健康接触、个人儿童健康记录和家庭安全评估中,一些家具坠落事件可能会得到预防。