P3A290: Window of Opportunity: Pediatric Window Fall Injuries at a Level 1 Trauma Center in Minnesota from 2012 to 2022

Background: Unintentional injuries are a leading cause of death in children, and falls are an important source of unintentional injury. Falls from windows specifically are a significant cause of morbidity and mortality in pediatric patients, leading to an average of 5180 annual emergency department visits from 1990-2008. There is a lack of recent data about window falls in pediatric patients, representing an important knowledge gap for injury prevention efforts. Hennepin County Medical Center (HCMC) in Minneapolis, MN, is a level 1 trauma center with a large catchment area including much of Minnesota and regions of neighboring Wisconsin, Iowa, and North and South Dakota. As such, pediatric trauma patients served by HCMC are a good representation of the pediatric trauma burden in the region.

Methods: The Hennepin Trauma Registry (a fully de-identified database) was used for this study. Data for patients ages 0-17 years old (yo) who presented to HCMC after falling out of a window from 2012-2022 were analyzed. Data obtained included patient age, sex, race, payor type, fall height, types of injuries sustained, injury severity score, and survival. Descriptive analyses of the data collected were conducted in Excel 2023.

Results: From 2012 to 2022, 83 patients (55 male and 28 female) 0-17 yo presented to HCMC after falling from a window. 58% of falls occurred in children 0-3 yo, 27% in children 4-7 yo, and 15% in children 8-17 yo. 48% of patients were black or African American, 25% were white, 10% were Hispanic, 10% were an unknown or other race, 6% were Asian, and 1% were American Indian. The majority (54%) were Medicaid recipients. The most common injuries sustained included mild traumatic brain injury (29%), intracranial hemorrhage (21%), skull fracture (17%), and spinal fracture (8%). There was one death in a 2 yo patient. Falls from second story and third story or higher windows were the most common (46% and 38% of falls, respectively). The majority of patients (60%) had an injury severity score of 0 to 9, while 16% had a score of 10 to 15, 24% had a score of 16 to 24, and 4% had a score of 25 or greater.

Conclusion: Most patients who fell from windows were very young (0-3 yo), with this age group accounting for the only death. Head and spine injuries were the most common injuries sustained, which may result in serious, life-long morbidity. Black, indigenous, and people of color and Medicaid patients comprised a majority of the cohort studied, suggesting that social factors are an important consideration for further study and injury prevention efforts, including legislative advocacy. Future directions of study include analysis of similar data from a national database. Nationwide data on this subject have not been published since 2011.