Mulligan Christopher S, Adams Susan, Tzioumi Dimitra, Brown Julie
School of Women's and Children's Health, University of New South Wales, Sydney, New South Wales, Australia.
Prince of Wales Clinical School, University of New South Wales, Sydney, New South Wales, Australia.
J Paediatr Child Health. 2017 Aug;53(8):754-760. doi: 10.1111/jpc.13568. Epub 2017 Jun 26.
Falls in infants are a common cause of injury. Compared to older children, infants under age one are likely to have distinctive causation and injury patterns, as they are pre-mobile or have limited independent mobility and falls are more directly the responsibility of the care giver. There is little known about the mechanistic factors, predictors of injury and injury patterns in this age group.
We conducted a retrospective review of infants under age one who presented after a fall to a paediatric trauma centre in Sydney, Australia. Circumstances and mechanisms of the fall, injury patterns, burden of investigations and outcomes were analysed.
Over a 3-year period (2011-2013), 916 infants presented following a fall. One hundred and six (11.6%) were admitted and there was one death. Head injury was the most common reason for admission (85%). While there were severe and critical head injuries (Abbreviated Injury Scale 4-5) these were infrequent (2% of presentations). All admitted cases involved a short distance fall. Patients dropped by others were three times more likely to be admitted than infants presenting following other fall types (95% CI 1.9-4.8). Compared to other mechanisms, patients who fell from furniture had significantly longer hospital stays.
Fall mechanisms involving infants being dropped by adults, and falls from beds or couches carry the highest clinical burden. These mechanisms should be targets for injury prevention and inform the design of safe equipment and environments for babies.
婴儿跌倒为常见的受伤原因。与大龄儿童相比，一岁以下婴儿的跌倒原因及受伤模式可能具有独特性，因为他们处于不能自主活动或自主活动受限阶段，跌倒更多是护理者的直接责任。目前对于该年龄组跌倒的机制因素、受伤预测因素及受伤模式了解甚少。
我们对澳大利亚悉尼一家儿科创伤中心收治的一岁以下跌倒婴儿进行了回顾性研究。分析了跌倒的情况和机制、受伤模式、检查负担及结果。
在2011年至2013年的3年期间，916名婴儿因跌倒前来就诊。其中106名（11.6%）入院治疗，1例死亡。头部受伤是入院的最常见原因（85%）。虽然存在严重和极重度头部损伤（简明损伤定级标准4 - 5级），但此类情况并不常见（占就诊病例的2%）。所有入院病例均为短距离跌倒。被他人扔下的患儿入院可能性是其他跌倒类型患儿的3倍（95%置信区间1.9 - 4.8）。与其他机制相比，从家具上跌落的患儿住院时间显著更长。
涉及成人扔下婴儿以及从床或沙发上跌落的跌倒机制临床负担最重。这些机制应作为预防受伤的目标，并为婴儿安全设备及环境的设计提供依据。
