Fall-related pediatric brain injuries: the role of race, age, and sex.
BACKGROUND
Falls remain a major cause of childhood morbidity and mortality. To improve effectiveness of our prevention program, we used our electronic injury surveillance database to analyze patient variables and the incidence of fall-related brain injury.


METHODS
The database was queried for all injuries treated in the pediatric emergency department for which the word "fall" was listed as part of the chief complaint. Age, sex, and mechanism variables were cross tabulated for analysis with traumatic brain injury (TBI) codes.


RESULTS
Between June 2005 and June 2008, the electronic surveillance system reported 39,718 injury-related visits to the pediatric emergency department. Falls were reported in 3,436 patients (2,107 males, 1,329 females). TBI occurred from falls in 171 patients. Although black children had a higher fall rate (69.24%) than white children (23.75%) and non-black, non-white children (7.01%), white children had the highest TBI rate from falls (9.47%). TBI from falls occurred at a lower mean age for females (5.40 +/- 4.45) than males (6.6 +/- 5.15) and for non-whites (5.98 +/- 4.88) than whites (6.21 +/- 4.93). Multiple logistic regression demonstrated a significant influence of age, race, and sex on the likelihood that a fall results in TBI. Females have a higher risk of TBI from falls than males from ages 0 to 11.5. This runs contrary to previous studies suggesting that toddler males are at highest risk for TBI.


CONCLUSIONS
A disproportionate number of infants, toddlers, and adolescents sustain brain injury from falls. Race and sex group differences mandate enhanced focus on environmental safety and risk-taking behaviors.
Love
Pamela F
PF
Department of Pediatric Emergency Medicine, University of Florida College of Medicine/Jacksonville, Jacksonville, Florida 32209, USA. jjt@jax.ufl.edu
Tepas
Joseph J
JJ
Wludyka
Peter S
PS
Masnita-Iusan
Carmen
C
D000058:Accidental Falls / Q000706:statistics & numerical data*; D000293:Adolescent; D000367:Age Factors; D001930:Brain Injuries / Q000453:epidemiology* / Q000208:ethnology*; D002648:Child; D002675:Child, Preschool; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data; D005260:Female; D005431:Florida / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D007223:Infant; D016015:Logistic Models; D008297:Male; D011159:Population Surveillance; D012307:Risk Factors; D012737:Sex Factors