ARTICLE IN PRESS JID: JINJ [m5G;October 9, 2020;12:41] Injury xxx (xxxx) xxx Contents lists available at ScienceDirect Injury journal homepage: www.elsevier.com/locate/injury Characteristics of injuries among infants who fall from bed Kamil Kokulu * , Abdullah Algın , Serdar Özdemir , Hatice ¸ Seyma Akça Department of Emergency Medicine, Ümraniye Training and Research Hospital, University of Health Sciences, ˙ Istanbul, Turkey a r t i c l e i n f o Article history: Accepted 3 October 2020 Available online xxx Keywords: Falls Infant Injury Bed Prevention a b s t r a c t Introduction: Accidental falls are the most common causes of injury among infants. Due to their limited ability to move independently, falling from bed or other types of furniture (such as sofas or armchairs) is considered the most common reason for such injury. However, little is known about the frequency and types of injury associated with this type of fall among infants. This study aimed to determine the incidence and characteristics of injury among infants presented at emergency departments (ED) after falling from bed or similar furniture. Methods: The retrospective analysis of infants under one year old presenting at ED after falling from bed (or similar furniture) was performed over a four-year period (2016–2019). Patient demographics, in- cidence and patterns of injury, outcomes, and ED resources use were evaluated as part of the study. Results: In total, 1,439 infants were included in the study, of whom 782 (54.3%) were male and 657 (45.7%) female. The median age of the patients was 7 months (interquartile range [IQR]: 6–9 months). More than half the infants (n = 812, 56.4%) had minor injuries, such as abrasions, bruising, contusions, and lacerations. There were significant injuries for 135 (9.4%) infants. The most common fracture was skull fracture (n = 59, 4.1%), followed by proximal fracture of the upper extremities (n = 26, 1.8%). Six (0.4%) patients had radial head subluxation. Traumatic brain injury featured for 30 (2.1%) infants (intracra- nial hemorrhage/cerebral contusion). While the majority of patients (n = 1352, 94%) were discharged from ED, 86 (6%) infants were hospitalized, all due to head injuries. A neurosurgical intervention was performed with three (0.2% of all patients) of the hospitalized patients. Conclusion: Falling from bed causes skull fractures, traumatic brain injury, and long bone fractures among infants. Therefore, campaigns should be organized to raise awareness of these risks among parents and caregivers of infants. In addition, the use of safety equipment (such as bed rails) and creating a safe environment can help prevent significant injuries. © 2020 Elsevier Ltd. All rights reserved. Introduction Unintentional falls rarely cause death among infants under one year of age, but they are the leading cause of non-fatal injuries [1]. Between 2000 and 2018, approximately 2.3 million infants were presented to emergency departments (EDs) due to unintentional falls in the United States [1]. However, today there is still little in- formation about unintentional falls in infancy. This age group dif- fers from other children due to their physiological and anatomical features. For example, infants generally have limited mobility. From infants under one year old, while the younger ones are usually pre- * Corresponding author: Kamil Kokulu, Ümraniye Training and Research Hospital, Department of Emergency Medicine. Elmalıkent Mahallesi Adem Yavuz Cad. No:1 Ümraniye / ˙ Istanbul PK: 34764 ˙ Istanbul/Turkey. E-mail address: drkokulu@gmail.com (K. Kokulu). mobile, the older ones have limited mobility such as rolling and crawling. The activities of babies are primarily determined by their par- ents or caregivers. Therefore, the mechanisms and injury patterns that cause infants to accidentally fall will differ from those ob- served among older children. Since infants have limited mobility, the most frequent reason for falls in this age group is falling from bed or similar furniture (such as sofa, baby cot, or armchair) [2– 4]. Of babies younger than 6 months, 22 percent experience falling from bed or similar furniture at least once [5]. Although it is a common phenomenon, our knowledge of this type of injury in in- fants remains limited. Studies on falling from bed or similar furni- ture have generally examined children among all age groups, not specifically infants [6–9]. In addition, the number of infants in- cluded in these studies is much lower compared to those con- ducted with other age groups. Studies that only examine infants are generally surveys conducted with parents [5]. Therefore, the https://doi.org/10.1016/j.injury.2020.10.015 0020-1383/© 2020 Elsevier Ltd. All rights reserved. Please cite this article as: K. Kokulu, A. Algın, S. Özdemir et al., Characteristics of injuries among infants who fall from bed, Injury, https://doi.org/10.1016/j.injury.2020.10.015