Chiaviello C T, Christoph R A, Bond G R
Department of Pediatrics, University of Virginia, Charlottesville 22908.
Pediatrics. 1994 Nov;94(5):679-81.
To identify the pattern and severity of injury associated with stairway-related falls in children.
During a 2-year period, all children less than 5 years of age presenting to the University of Virginia Pediatric Emergency Department with a stairway-related injury were prospectively studied. At the time of the emergency department visit, demographic and epidemiologic information was obtained. Injuries were assigned E codes and N codes. A Modified Injury Severity Scale (MISS) score was calculated for each child. Excluded from the study were children with suspected intentional trauma and children with walker-related stairway injuries.
Sixty-nine children were enrolled in the study. The median age was 2 years. Head and neck injuries occurred in 90% of the patients, extremity injuries in 6%, and truncal injuries in 4%. Injury to more than one body region did not occur. The majority of injuries were minor. Ninety-six percent had a total MISS score < or = 2. Fifteen patients (22%) suffered significant injuries, including concussion in 11 (16%), skull fracture in 5 (7%), cerebral contusion in 2 (3%), subdural hematoma in 1 (1%), and a C-2 fracture in 1 (1%).
The majority of stairway-related injuries are minor. Injuries to the head and neck region predominate. Injuries to multiple body regions are rare. However, significant stairway-related injuries may be more common than previously reported.
确定与儿童楼梯相关跌倒有关的损伤模式和严重程度。
在两年期间，对所有小于5岁因楼梯相关损伤就诊于弗吉尼亚大学儿科急诊科的儿童进行前瞻性研究。在急诊科就诊时，获取人口统计学和流行病学信息。损伤被分配E编码和N编码。为每个儿童计算改良损伤严重程度量表（MISS）评分。排除疑似故意创伤的儿童和与助行器相关的楼梯损伤儿童。
69名儿童纳入研究。中位年龄为2岁。90%的患者发生头颈部损伤，6%发生四肢损伤，4%发生躯干损伤。未发生一个以上身体部位的损伤。大多数损伤为轻伤。96%的患者MISS总分≤2。15名患者（22%）遭受严重损伤，包括11例（16%）脑震荡、5例（7%）颅骨骨折、2例（3%）脑挫伤、1例（1%）硬膜下血肿和1例（1%）C-2骨折。
大多数与楼梯相关的损伤为轻伤。头颈部损伤占主导。多个身体部位的损伤罕见。然而，与楼梯相关的严重损伤可能比以前报道的更常见。
