Fall-related attendance and associated hospitalisation of children and adolescents in Hong Kong: a 12-year retrospective study

BMJ Open. 2017 Feb 7;7(2):e013724. doi: 10.1136/bmjopen-2016-013724.

Abstract

Objectives: The present study aimed to examine the trends and characteristics of fall-related attendance in accident and emergency department (AED) by injury type and the trend in associated average length of stay (LOS) among children and adolescents in Hong Kong.

Design: A retrospective approach was adopted.

Setting: AED, involving all local public emergency departments from 2001 to 2012.

Participants: 63 557 subjects aged 0-19 years with fall injury record were included in the analysis.

Primary outcome measures: Fall-related injury number and rates were calculated and reported. Poisson and negative binomial regression models were used to study the trends of injury incidence rate at different body regions.

Results: AED fall-related attendance rate increased significantly with an annual percentage change of 4.45 (95% CI 3.43 to 5.47%, p<0.0001). The attendance number of male subjects was persistently higher than female subjects. The standardised rate of fracture injury increased by 1.31% (95% CI 0.56 to 2.05%, p<0.0001) and that of non-fracture injury increased by 9.23% (95% CI 7.07 to 11.43%, p<0.0001) annually. Upper limb was the most frequently fractured location. It included forearm/elbow, shoulder/upper arm and wrist/hand with descending order of frequency. On the contrary, head was the most frequent non-fracture location, followed by forearm/elbow.

Conclusions: The rates of fall-related attendance have been increasing and still remain high. There were significant increases in non-fracture injuries. Fractures were most frequently found in the upper extremity of a child while the most common non-fracture location was head. It appears that more efforts should be made and preventive measures should be implemented for children and adolescents in Hong Kong.

MeSH terms

  • Accidental Falls / statistics & numerical data*
  • Adolescent
  • Child
  • Child, Preschool
  • Craniocerebral Trauma / epidemiology*
  • Emergency Service, Hospital / statistics & numerical data*
  • Female
  • Fractures, Bone / epidemiology*
  • Hong Kong / epidemiology
  • Hospitalization / statistics & numerical data*
  • Humans
  • Infant
  • Infant, Newborn
  • Length of Stay / statistics & numerical data
  • Male
  • Retrospective Studies
  • Sex Distribution
  • Upper Extremity / injuries*
  • Wounds and Injuries / epidemiology
  • Young Adult