Division of Pediatric Critical Care Medicine, MassGeneral Hospital for Children (MR Flaherty and P Yager), Boston, Mass; Northeast Pediatric Intensive Care Consortium (MR Flaherty, P Yager, JS Giuliano, and C McKiernan), Boston, Mass.
Department of Surgery, Division of Trauma, Emergency Services, and Surgical Critical Care, Massachusetts General Hospital (T Raybould), Boston, Mass.
Acad Pediatr. 2021 Apr;21(3):497-503. doi: 10.1016/j.acap.2020.07.008. Epub 2020 Jul 9.
Unintentional window falls represent a preventable source of injury and death in children. Despite major campaigns in some larger cities, there continue to be unintentional falls from windows throughout the United States. We aimed to identify risk factors and trends in unintentional window falls in the pediatric population in a national and regional sample.
A retrospective analysis of annual emergency department (ED) visits from the National Electronic Injury Surveillance System using product codes specific to windows, as well as patient encounters for unintentional window falls from January 2007 to August 2017 using site-specific trauma registries from 10 tertiary care children's hospitals in New England. National and state-specific census population estimates were used to compute rates per 100,000 population.
There were 38,840 ED visits and 496 regional patients who unintentionally fell from a window across the study period between 0 and 17 years old. The majority of falls occurred in children under the age of 6 and were related to falls from a second story or below. A decreased trend in national ED visits was seen, but no change in rates over time for regional trauma center encounters. A high number of falls was found to occur in smaller cities surrounding metropolitan areas and from single family residences.
Falls from windows represent a low proportion of overall types of unintentional sources of injury in children but are a high risk for severe disability. These results provide updated epidemiologic data for targeted intervention programs, as well as raise awareness for continued education and advocacy.
儿童非故意坠窗事件是可预防的伤害和死亡源头。尽管在一些较大的城市开展了重大活动,但全美仍有非故意坠窗事件发生。我们旨在确定全国和地区样本中儿科人群非故意坠窗的风险因素和趋势。
利用国家电子伤害监测系统中特定于窗户的产品代码,对 2007 年 1 月至 2017 年 8 月期间每年的急诊就诊情况进行回顾性分析,同时利用新英格兰地区 10 家三级儿童护理医院特定地点创伤登记处,对非故意坠窗的患者就诊情况进行分析。使用全国和州特定的人口普查估计数计算每 10 万人的发生率。
在研究期间(0 至 17 岁),全国有 38840 次 ED 就诊,地区有 496 名患者非故意从窗户坠落。大多数坠落事件发生在 6 岁以下的儿童中,与从二楼或以下坠落有关。全国 ED 就诊人数呈下降趋势,但地区创伤中心就诊人数在一段时间内没有变化。在大都市周边的小城市和单户住宅中,发现有大量的坠窗事件发生。
坠窗虽然仅占儿童所有非故意伤害源的一小部分,但却是导致严重残疾的高风险因素。这些结果为有针对性的干预计划提供了最新的流行病学数据,并提高了对持续教育和宣传的认识。