Background Falls are the most common type of unintentional injury among the pediatric population in the United States. Falls from windows have been repeatedly shown to occur with remarkable frequency in both urban and suburban settings, and with notable associated morbidity and mortality. Despite this knowledge, little is known about the environmental risk factors and External Cause of Injury Codes (E-codes) associated with these particular types of falls. We performed a pilot study to assess these important issues.
Study Design and Methods We conducted a retrospective medical record review of 897 Emergency Department visits at Harborview Medical Center. We included children between the ages of 0 and 10 years of age who had been assigned E-codes of either E888.x, E884.x, E884.9, or E882. We tested both the sensitivity and specificity of External Cause of Injury Codes assigned by professional institutional coders to window falls.
Results Of the fall events we found (897 fall related events), 8.7% (78) were falls from windows. Of these window falls, 58% of the fall victims were male and 32% were female. 94.9% of the window fall victims were between the ages of 1 and 6 years of age. 81% of the window falls occurred in the Spring and Summer months. Also, 9.7% of the total falls observed and 84.6% of the window falls were coded as E882. We found the sensitivity and specificity for E-code E882 to be 84.6% and 97.4% respectively. Along with this E-code, we found the specificities and sensitivities of the following E-codes E884.9 (Sensitivity: 9.0%, Specificity: 73.0%), E888.1 (1.3%, 97.7%), E888 (6.4%, 54.6%), and E884.2 (1.3%, 98.4%).
Conclusions We found that of the E-codes assigned by institutional coders, E882 produced the highest combined sensitivity and specificity for window fall accidents. We also identified some useful environmental and epidemiological factors associated with this particular fall type. These data will be useful in a study of window falls in the Pacific Northwest to define this risk further as an important cause of pediatric injury.
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