Research Article
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Fall From Height Cases of Pediatric Intensive Care Unit and The Curfew of the COVID-19 Period Possible Effects on it

Year 2023, Volume: 14 Issue: 4 - Cumhuriyet'in 100. Yılına Armağan Sayısı, 594 - 602, 01.10.2023
https://doi.org/10.31067/acusaglik.1346102

Abstract

Background/Purpose: To investigate whether the curfew of the COVID-19 pandemic influences the fall from height cases in children’s age group.
Methods: This study was conducted in the Pediatric Intensive Care Unit (PICU) of XXX Training and Research Hospital between 01 January 2017 and 01 January 2022. This study enrolled 39 males (35.1%) and 72 females (64.9%) aged 4.4 ±4.1 years.
Results: The findings indicate that when the school precautions existed, the number of fall cases who were admitted to PICU decreased 10-fold. Additionally, when the general precautions were performed, the number of fall cases who were admitted to PICU decreased 31,8%. On the other hand, the logistic regression model, which was established to predict the independent factors of higher fall cases among all of the fall cases admitted to PICU, was found to be significant. Falling from the 'storey of building', which is one of the variables included in the analysis, contributed significantly to the model and was in a 54.4-fold significant relationship with High Falls (above 4.57 meters). While pneumocephalus injury was associated with High Falls 9.2 times, pneumothorax was associated 15.9 times.
Conclusion: Our results have three implications. First, it was presented that above 4,57 meter falls cause more severe injuries than lower falls. Second, injury patterns, social parameters, epidemiological differences, required prevention equipment, and education of caregivers of fall cases were revealed. Third, the influences of the curfew on the COVID-19 pandemic were discussed.

References

  • Turgut K, Sarihan ME, Colak C, et al. Falls from height: A retrospective analysis. World J Emerg Med. 2018;9(1):46-50. doi: 10.5847/wjem.j.1920-8642.2018.01.007. PMID: 29290895; PMCID: PMC5717375.
  • Johnston BD, Rivara FP. The Field of Pediatrics, Chapter 13: Injury Control: Part I:pg:79:2022
  • Pérez-Suárez E, Jiménez-García R, Iglesias-Bouzas M, et al. J. Caídas desde grandes alturas en Pediatría. Epidemiología y evolución de 54 pacientes [Falls from heights in Pediatrics. Epidemiology and evolution of 54 patients]. Med Intensiva. 2012 Mar;36(2):89-94. Spanish. doi: 10.1016/j.medin.2011.08.013. Epub 2011 Oct 19. PMID: 22014708.
  • Cheng P, Wang L, Ning P, et al. Unintentional falls mortality in China, 2006-2016. J Glob Health. 2019 Jun;9(1):010603. doi: 10.7189/jogh.09.010603. PMID: 30992985; PMCID: PMC6445498.
  • Tuckel P, Milczarski W, Silverman DG. Injuries Caused by Falls From Playground Equipment in the United States. Clin Pediatr (Phila). 2018 May;57(5):563-573. doi: 10.1177/0009922817732618. Epub 2017 Oct 2. PMID: 28969430.
  • https://data.tuik.gov.tr/Bulten/Index?p=Olum-Nedeni-Istatistikleri-2018-30626 (Accessed on 01/09/2022)
  • https://www.icisleri.gov.tr/kademeli-normallesme-tedbirleri-genelgesi (Accessed on 01/09/2022)
  • Murray JA, Chen D, Velmahos GC, et al. Pediatric falls: is height a predictor of injury and outcome? Am Surg. 2000 Sep;66(9):863-5. PMID: 10993618.
  • Calis S, Calis C, Kocali K, et al. "18-65 Yaş arası kişilerin antropometrik verilerinin belirlenmesi üzerine bir alan araştırması: yükseköğretim kurumu uygulaması." Ergonomi 4.3 (2021): 147-161.
  • Wang H, Yu H, Zhou Y, et al. Traumatic fractures as a result of falls in children and adolescents: A retrospective observational study. Medicine (Baltimore). 2017 Sep;96(37):e7879. doi: 10.1097/MD.0000000000007879. PMID: 28906368; PMCID: PMC5604637.
  • Lehman D, Schonfeld N. Falls from heights: a problem not just in the northeast. Pediatrics. 1993 Jul;92(1):121-4. PMID: 8516056.
  • Vish NL, Powell EC, Wiltsek D, et al. Pediatric window falls: not just a problem for children in high rises. Inj Prev. 2005 Oct;11(5):300-3. doi: 10.1136/ip.2005.008664. PMID: 16203839; PMCID: PMC1730276.
  • Khambalia A, Joshi P, Brussoni M, et al. Risk factors for unintentional injuries due to falls in children aged 0-6 years: a systematic review. Inj Prev. 2006 Dec;12(6):378-81. doi: 10.1136/ip.2006.012161. PMID: 17170185; PMCID: PMC2564414.
  • Chaudhary S, Figueroa J, Shaikh S, et al. Pediatric falls ages 0-4: understanding demographics, mechanisms, and injury severities. Inj Epidemiol. 2018 Apr 10;5(Suppl 1):7. doi: 10.1186/s40621-018-0147-x. PMID: 29637431; PMCID: PMC5893510.
  • Kocak S, Dundar ZD, Yavuz K, et al. Etiologic factors in falls from height in pediatric cases. Eur J Trauma Emerg Surg. 2012 Jun;38(3):313-7. doi: 10.1007/s00068-011-0172-8. Epub 2012 Jan 4. PMID: 26815964.
  • Muneshige K, Miyagi M, Inoue G, et al. The Relationship Between Falling Distance and Trauma Severity Among Fall Injury Survivors Who Were Transported to a Trauma Center. Cureus. 2022 May 18;14(5):e25099. doi: 10.7759/cureus.25099. PMID: 35733504; PMCID: PMC9205290.
  • Pressley JC, Barlow B. Child and adolescent injury as a result of falls from buildings and structures. Inj Prev. 2005 Oct;11(5):267-73. doi: 10.1136/ip.2004.007724. PMID: 16203834; PMCID: PMC1730275.
  • Santer LJ, Stocking CB. Safety practices and living conditions of low-income urban families. Pediatrics. 1991 Dec;88(6):1112-8. PMID: 1956727.
  • Faelker T, Pickett W, Brison RJ. Socioeconomic differences in childhood injury: a population based epidemiologic study in Ontario, Canada. Inj Prev. 2000 Sep;6(3):203-8. doi: 10.1136/ip.6.3.203. PMID: 11003186; PMCID: PMC1730634.
  • Gyedu A, Boakye G, Quansah R, et al. Unintentional falls among children in rural Ghana and associated factors: a cluster-randomized, population-based household survey. Pan Afr Med J. 2021 Apr 26;38:401. doi: 10.11604/pamj.2021.38.401.28313. PMID: 34381545; PMCID: PMC8325452.
  • Bögli J, Güsewell S, Strässle R, et al. Pediatric hospital admissions, case severity, and length of hospital stay during the first 18 months of the COVID-19 pandemic in a tertiary children's hospital in Switzerland. Infection. 2023 Apr;51(2):439-446. doi: 10.1007/s15010-022-01911-x. Epub 2022 Sep 5. PMID: 36065045; PMCID: PMC9444086.
  • Kalem M, Özbek EA, Kocaoğlu H, et al. The increase in paediatric orthopaedic trauma injuries following the end of the curfew during the COVID-19 period. J Child Orthop. 2021 Aug 20;15(4):409-414. doi: 10.1302/1863-2548.15.210071. PMID: 34476032; PMCID: PMC8381397.
  • Sephton BM, Mahapatra P, Shenouda M, et al. The effect of COVID-19 on a Major Trauma Network. An analysis of mechanism of injury pattern, referral load and operative case-mix. Injury. 2021 Mar;52(3):395-401. doi: 10.1016/j.injury.2021.02.035. Epub 2021 Feb 17. PMID: 33627252; PMCID: PMC7897366.
  • Aydın O, Hanalıoğlu D, Ünal B, et al. What Has Changed in Injury-Related Presentations During COVID-19 Pandemic? A Single-Center Experience from a Pediatric Emergency Department. Turk Arch Pediatr. 2022 Jul;57(4):453-458. doi: 10.5152/TurkArchPediatr.2022.22032. PMID: 35822479; PMCID: PMC9321838.
  • McGuinness MJ, Hsee L. Impact of the COVID-19 national lockdown on emergency general surgery: Auckland City Hospital's experience. ANZ J Surg. 2020 Nov;90(11):2254-2258. doi: 10.1111/ans.16336. Epub 2020 Sep 23. PMID: 32940409.
  • Keays G, Friedman D, Gagnon I. Injuries in the time of COVID-19. Health Promot Chronic Dis Prev Can. 2020 Dec 9;40(11-12):336-341. doi: 10.24095/hpcdp.40.11/12.02. Epub 2020 Sep 11. PMID: 32924925; PMCID: PMC7745832.
  • Giudici R, Lancioni A, Gay H, et al. Impact of the COVID-19 outbreak on severe trauma trends and healthcare system reassessment in Lombardia, Italy: an analysis from the regional trauma registry. World J Emerg Surg. 2021 Jul 19;16(1):39. doi: 10.1186/s13017-021-00383-y. PMID: 34281575; PMCID: PMC8287111.
  • Chiba H, Lewis M, Benjamin ER, et al. "Safer at home": The effect of the COVID-19 lockdown on epidemiology, resource utilization, and outcomes at a large urban trauma center. J Trauma Acute Care Surg. 2021 Apr 1;90(4):708-713. doi: 10.1097/TA.0000000000003061. PMID: 33347094; PMCID: PMC7996058.
  • Ferro V, Nacca R, Pisani M, et al. Children at risk of domestic accidents when are locked up at home: the other side of COVID-19 outbreak lockdown. Ital J Pediatr. 2022 Jul 27;48(1):129. doi: 10.1186/s13052-022-01318-2. PMID: 35897106; PMCID: PMC9326437.
  • Bruns N, Willemsen LY, Holtkamp K, et al. Impact of the First COVID Lockdown on Accident- and Injury-Related Pediatric Intensive Care Admissions in Germany-A Multicenter Study. Children (Basel). 2022;9(3):363. Published 2022 Mar 4. doi:10.3390/children9030363
Year 2023, Volume: 14 Issue: 4 - Cumhuriyet'in 100. Yılına Armağan Sayısı, 594 - 602, 01.10.2023
https://doi.org/10.31067/acusaglik.1346102

Abstract

References

  • Turgut K, Sarihan ME, Colak C, et al. Falls from height: A retrospective analysis. World J Emerg Med. 2018;9(1):46-50. doi: 10.5847/wjem.j.1920-8642.2018.01.007. PMID: 29290895; PMCID: PMC5717375.
  • Johnston BD, Rivara FP. The Field of Pediatrics, Chapter 13: Injury Control: Part I:pg:79:2022
  • Pérez-Suárez E, Jiménez-García R, Iglesias-Bouzas M, et al. J. Caídas desde grandes alturas en Pediatría. Epidemiología y evolución de 54 pacientes [Falls from heights in Pediatrics. Epidemiology and evolution of 54 patients]. Med Intensiva. 2012 Mar;36(2):89-94. Spanish. doi: 10.1016/j.medin.2011.08.013. Epub 2011 Oct 19. PMID: 22014708.
  • Cheng P, Wang L, Ning P, et al. Unintentional falls mortality in China, 2006-2016. J Glob Health. 2019 Jun;9(1):010603. doi: 10.7189/jogh.09.010603. PMID: 30992985; PMCID: PMC6445498.
  • Tuckel P, Milczarski W, Silverman DG. Injuries Caused by Falls From Playground Equipment in the United States. Clin Pediatr (Phila). 2018 May;57(5):563-573. doi: 10.1177/0009922817732618. Epub 2017 Oct 2. PMID: 28969430.
  • https://data.tuik.gov.tr/Bulten/Index?p=Olum-Nedeni-Istatistikleri-2018-30626 (Accessed on 01/09/2022)
  • https://www.icisleri.gov.tr/kademeli-normallesme-tedbirleri-genelgesi (Accessed on 01/09/2022)
  • Murray JA, Chen D, Velmahos GC, et al. Pediatric falls: is height a predictor of injury and outcome? Am Surg. 2000 Sep;66(9):863-5. PMID: 10993618.
  • Calis S, Calis C, Kocali K, et al. "18-65 Yaş arası kişilerin antropometrik verilerinin belirlenmesi üzerine bir alan araştırması: yükseköğretim kurumu uygulaması." Ergonomi 4.3 (2021): 147-161.
  • Wang H, Yu H, Zhou Y, et al. Traumatic fractures as a result of falls in children and adolescents: A retrospective observational study. Medicine (Baltimore). 2017 Sep;96(37):e7879. doi: 10.1097/MD.0000000000007879. PMID: 28906368; PMCID: PMC5604637.
  • Lehman D, Schonfeld N. Falls from heights: a problem not just in the northeast. Pediatrics. 1993 Jul;92(1):121-4. PMID: 8516056.
  • Vish NL, Powell EC, Wiltsek D, et al. Pediatric window falls: not just a problem for children in high rises. Inj Prev. 2005 Oct;11(5):300-3. doi: 10.1136/ip.2005.008664. PMID: 16203839; PMCID: PMC1730276.
  • Khambalia A, Joshi P, Brussoni M, et al. Risk factors for unintentional injuries due to falls in children aged 0-6 years: a systematic review. Inj Prev. 2006 Dec;12(6):378-81. doi: 10.1136/ip.2006.012161. PMID: 17170185; PMCID: PMC2564414.
  • Chaudhary S, Figueroa J, Shaikh S, et al. Pediatric falls ages 0-4: understanding demographics, mechanisms, and injury severities. Inj Epidemiol. 2018 Apr 10;5(Suppl 1):7. doi: 10.1186/s40621-018-0147-x. PMID: 29637431; PMCID: PMC5893510.
  • Kocak S, Dundar ZD, Yavuz K, et al. Etiologic factors in falls from height in pediatric cases. Eur J Trauma Emerg Surg. 2012 Jun;38(3):313-7. doi: 10.1007/s00068-011-0172-8. Epub 2012 Jan 4. PMID: 26815964.
  • Muneshige K, Miyagi M, Inoue G, et al. The Relationship Between Falling Distance and Trauma Severity Among Fall Injury Survivors Who Were Transported to a Trauma Center. Cureus. 2022 May 18;14(5):e25099. doi: 10.7759/cureus.25099. PMID: 35733504; PMCID: PMC9205290.
  • Pressley JC, Barlow B. Child and adolescent injury as a result of falls from buildings and structures. Inj Prev. 2005 Oct;11(5):267-73. doi: 10.1136/ip.2004.007724. PMID: 16203834; PMCID: PMC1730275.
  • Santer LJ, Stocking CB. Safety practices and living conditions of low-income urban families. Pediatrics. 1991 Dec;88(6):1112-8. PMID: 1956727.
  • Faelker T, Pickett W, Brison RJ. Socioeconomic differences in childhood injury: a population based epidemiologic study in Ontario, Canada. Inj Prev. 2000 Sep;6(3):203-8. doi: 10.1136/ip.6.3.203. PMID: 11003186; PMCID: PMC1730634.
  • Gyedu A, Boakye G, Quansah R, et al. Unintentional falls among children in rural Ghana and associated factors: a cluster-randomized, population-based household survey. Pan Afr Med J. 2021 Apr 26;38:401. doi: 10.11604/pamj.2021.38.401.28313. PMID: 34381545; PMCID: PMC8325452.
  • Bögli J, Güsewell S, Strässle R, et al. Pediatric hospital admissions, case severity, and length of hospital stay during the first 18 months of the COVID-19 pandemic in a tertiary children's hospital in Switzerland. Infection. 2023 Apr;51(2):439-446. doi: 10.1007/s15010-022-01911-x. Epub 2022 Sep 5. PMID: 36065045; PMCID: PMC9444086.
  • Kalem M, Özbek EA, Kocaoğlu H, et al. The increase in paediatric orthopaedic trauma injuries following the end of the curfew during the COVID-19 period. J Child Orthop. 2021 Aug 20;15(4):409-414. doi: 10.1302/1863-2548.15.210071. PMID: 34476032; PMCID: PMC8381397.
  • Sephton BM, Mahapatra P, Shenouda M, et al. The effect of COVID-19 on a Major Trauma Network. An analysis of mechanism of injury pattern, referral load and operative case-mix. Injury. 2021 Mar;52(3):395-401. doi: 10.1016/j.injury.2021.02.035. Epub 2021 Feb 17. PMID: 33627252; PMCID: PMC7897366.
  • Aydın O, Hanalıoğlu D, Ünal B, et al. What Has Changed in Injury-Related Presentations During COVID-19 Pandemic? A Single-Center Experience from a Pediatric Emergency Department. Turk Arch Pediatr. 2022 Jul;57(4):453-458. doi: 10.5152/TurkArchPediatr.2022.22032. PMID: 35822479; PMCID: PMC9321838.
  • McGuinness MJ, Hsee L. Impact of the COVID-19 national lockdown on emergency general surgery: Auckland City Hospital's experience. ANZ J Surg. 2020 Nov;90(11):2254-2258. doi: 10.1111/ans.16336. Epub 2020 Sep 23. PMID: 32940409.
  • Keays G, Friedman D, Gagnon I. Injuries in the time of COVID-19. Health Promot Chronic Dis Prev Can. 2020 Dec 9;40(11-12):336-341. doi: 10.24095/hpcdp.40.11/12.02. Epub 2020 Sep 11. PMID: 32924925; PMCID: PMC7745832.
  • Giudici R, Lancioni A, Gay H, et al. Impact of the COVID-19 outbreak on severe trauma trends and healthcare system reassessment in Lombardia, Italy: an analysis from the regional trauma registry. World J Emerg Surg. 2021 Jul 19;16(1):39. doi: 10.1186/s13017-021-00383-y. PMID: 34281575; PMCID: PMC8287111.
  • Chiba H, Lewis M, Benjamin ER, et al. "Safer at home": The effect of the COVID-19 lockdown on epidemiology, resource utilization, and outcomes at a large urban trauma center. J Trauma Acute Care Surg. 2021 Apr 1;90(4):708-713. doi: 10.1097/TA.0000000000003061. PMID: 33347094; PMCID: PMC7996058.
  • Ferro V, Nacca R, Pisani M, et al. Children at risk of domestic accidents when are locked up at home: the other side of COVID-19 outbreak lockdown. Ital J Pediatr. 2022 Jul 27;48(1):129. doi: 10.1186/s13052-022-01318-2. PMID: 35897106; PMCID: PMC9326437.
  • Bruns N, Willemsen LY, Holtkamp K, et al. Impact of the First COVID Lockdown on Accident- and Injury-Related Pediatric Intensive Care Admissions in Germany-A Multicenter Study. Children (Basel). 2022;9(3):363. Published 2022 Mar 4. doi:10.3390/children9030363
There are 30 citations in total.

Details

Primary Language English
Subjects Intensive Care, Forensic Medicine, Clinical Sciences (Other), Environmental Health
Journal Section Research Article
Authors

Serbülent Kılıç 0000-0001-5224-4582

Arzu Oto 0000-0003-0229-2759

Musa Sahın 0000-0002-0736-2229

Early Pub Date September 23, 2023
Publication Date October 1, 2023
Submission Date August 18, 2023
Published in Issue Year 2023Volume: 14 Issue: 4 - Cumhuriyet'in 100. Yılına Armağan Sayısı

Cite

EndNote Kılıç S, Oto A, Sahın M (October 1, 2023) Fall From Height Cases of Pediatric Intensive Care Unit and The Curfew of the COVID-19 Period Possible Effects on it. Acıbadem Üniversitesi Sağlık Bilimleri Dergisi 14 4 594–602.