Pediatric Window Falls: Factors Related to Clinical Outcomes Within a State Trauma Registry

Abstract

Background

Accidental injuries are a common cause of morbidity and mortality in pediatrics. Among these, unintentional window falls are a common but preventable reason for emergency department presentations.

Objective

The objective of this study was to describe the demographics and characteristics of pediatric window falls and to identify geographic clusters of injury occurrences in Portland, Oregon.

Methods

Children treated at trauma centers in Portland, Oregon for unintentional window falls between 2005 and 2016 were identified retrospectively and data were collected exclusively from chart review. We then used specific fall addresses to create maps to visually identify clusters within the Portland metropolitan area.

Results

A total of 399 patients were included; median age was 3 years, with a male predominance (66%). Mortality was 1%. Most of the children fell from 2nd story windows (84%). Most children received at least one computed tomography scan, and the majority (72%) were admitted to the hospital. Landing on a hard surface (odds ratio [OR] 6.33, 95% confidence interval [CI] 3.22–12.46) and witnessed loss of consciousness (OR 2.11, 95% CI 1.04–4.25) were associated with increased odds of severe injury. Mapping visually demonstrated clusters in many neighborhoods that did not overlap with areas of highest population density.

Conclusion

Pediatric window falls in Oregon follow demographic trends previously identified by studies of window falls in other major metropolitan areas. Although the risk of death was low, many patients required workup and hospitalization. Using visuospatial mapping, we were able to identify geographic clusters of falls in the Portland area, where future preventative strategies could target these higher-risk areas.