Jiménez de Domingo Ana, Rubio García Elena, Marañon Pardillo Rafael, Arias Constanti Vanessa, Frontado Haiek Luis Alberto, Soriano Arola Marta, Ripoll Oliveras Francesc, Remón García Cristina, Estopiña Ferrer Gloria, Lorente Romero Jorge
Hospital General Universitario Gregorio Marañón, Madrid, España.
Hospital General Universitario Gregorio Marañón, Madrid, España.
An Pediatr (Barc). 2017 Jun;86(6):337-343. doi: 10.1016/j.anpedi.2015.12.004. Epub 2016 Feb 9.
To describe the epidemiological characteristics of unintentional injuries due to falls in children under one year and to analyse the risk factors associated with severe injuries.
This multicentre, observational and cross-sectional study included all children less than one year treated for unintentional fall in the Emergency Departments of 8 Spanish Hospitals, belonging to the «Unintentional Paediatric Injury Workshop» of the Spanish Paediatric Emergency Society, between March 1st, 2014 and February 28th, 2015.
Out of 289,887 emergency department cases, 1,022 were due to unintentional falls. The median age was 8 months and 52.5% were males. Fall injuries were more frequent among children aged 9-12 months (37.6%), and 83.5% occurred at home. The most common mechanism was fall from nursery equipment (69.4%), and 47.8% occurred from a height under 50cm. More than two-thirds (68%) of falls were witnessed, but in half of the cases (329) the caregiver was not in area. Serious injuries were seen in 12% of cases. In this study, a fall height greater than 50cm, falls in the street, from the arms of the carer, and from the stairs were identified as independent risk factors for worse outcomes.
The most serious injuries occur in children <3 months and from a height of >50cm, though not related to unwitnessed falls. Because the most common serious injury mechanism is the fall from the arms of the carer, from stairs, and falls in the street, these facts should be highlighted in order to avoid morbidity.
描述1岁以下儿童跌倒所致意外伤害的流行病学特征，并分析与重伤相关的危险因素。
这项多中心、观察性横断面研究纳入了2014年3月1日至2015年2月28日期间在西班牙8家医院急诊科接受治疗的所有1岁以下因意外跌倒的儿童，这些医院隶属于西班牙儿科急诊协会的“儿童意外伤害研讨会”。
在289,887例急诊病例中，1022例是由意外跌倒所致。中位年龄为8个月，男性占52.5%。9至12个月大的儿童跌倒受伤更为常见（37.6%），83.5%的跌倒发生在家中。最常见的机制是从育儿设备上跌落（69.4%），47.8%的跌落发生在50厘米以下的高度。超过三分之二（68%）的跌倒有目击者，但在一半的病例（329例）中，照顾者不在现场。12%的病例出现重伤。在本研究中，跌落高度大于50厘米、在街上跌倒、从照顾者怀中跌落以及从楼梯上跌落被确定为预后较差的独立危险因素。
最严重的伤害发生在3个月以下的儿童，且跌落高度大于50厘米，不过与无目击者的跌倒无关。由于最常见的严重伤害机制是从照顾者怀中跌落、从楼梯上跌落以及在街上跌倒，应强调这些情况以避免发病。
