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Objectives <p>Falls are a leading cause of non-fatal injury in young children, but limited research has explored the characteristics and risks associated with diaper change–related falls. This study aimed to determine whether diaper change-related falls are associated with higher proportions of head injuries than other falls in young children and identify risk factors.</p> Methods <p>This cross-sectional study analyzed data from the South Korea’s Emergency Department-based Injury In-depth Surveillance Registry 2011–2022 to examine fall injuries among children aged &lt; 3&#xa0;years. Diaper change-related injuries were identified using the International Classification of Diseases, Tenth Revision codes and narrative descriptions. Clinical outcomes (emergency department disposition, injury severity, head injury diagnoses, and injury sites) were compared between diaper- and non-diaper change-related falls. Logistic regression was used to identify factors associated with traumatic brain injuries (TBIs) and skull fractures.</p> Results <p>Among 51,474 fall injuries, 298 cases (0.6%) were diaper change-related, mostly occurring at home (63.4%) and involving infants aged &lt; 1&#xa0;year (81.2%). Diaper change-related falls were associated with higher proportions of TBI (47.3% vs. 31.0%; <i>p</i> &lt; 0.001) and severe injury (16.4% vs. 6.1%, <i>p</i> &lt; 0.001) than non-diaper change-related falls. In multivariable analysis, diaper change-related mechanisms were independently associated with increased odds of TBI (aOR 1.31, 95% CI 1.04–1.65; <i>p</i> = 0.024) and skull fracture (aOR 1.62, 95% CI 1.15–2.27; <i>p</i> = 0.006).</p> Conclusion <p>The proportion of diaper change-related falls among ED visits for falls in children aged 0 to &lt; 3&#xa0;years is increasing, particularly at home, and are associated with greater injury severity and risk of head trauma. Targeted caregiver education and national safety standards for diaper-changing equipment are needed to prevent these injuries.</p> Trial registration <p>Clinical trial number: Not applicable.</p>

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Traumatic brain injury from diaper change-related falls in children younger than 3 years: an evaluation of South Korean national emergency department registry data

  • 期刊论文

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  • 发表日期：

    2026年1月3日

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  • Minha Kim,
  • Sejin Heo,
  • Seung Jin Maeng,
  • Taerim Kim,
  • Hansol Chang,
  • Se Uk Lee,
  • Sung Yeon Hwang,
  • Won Chul Cha,
  • Hee Yoon

摘要

Objectives

Falls are a leading cause of non-fatal injury in young children, but limited research has explored the characteristics and risks associated with diaper change–related falls. This study aimed to determine whether diaper change-related falls are associated with higher proportions of head injuries than other falls in young children and identify risk factors.

Methods

This cross-sectional study analyzed data from the South Korea’s Emergency Department-based Injury In-depth Surveillance Registry 2011–2022 to examine fall injuries among children aged < 3 years. Diaper change-related injuries were identified using the International Classification of Diseases, Tenth Revision codes and narrative descriptions. Clinical outcomes (emergency department disposition, injury severity, head injury diagnoses, and injury sites) were compared between diaper- and non-diaper change-related falls. Logistic regression was used to identify factors associated with traumatic brain injuries (TBIs) and skull fractures.

Results

Among 51,474 fall injuries, 298 cases (0.6%) were diaper change-related, mostly occurring at home (63.4%) and involving infants aged < 1 year (81.2%). Diaper change-related falls were associated with higher proportions of TBI (47.3% vs. 31.0%; p < 0.001) and severe injury (16.4% vs. 6.1%, p < 0.001) than non-diaper change-related falls. In multivariable analysis, diaper change-related mechanisms were independently associated with increased odds of TBI (aOR 1.31, 95% CI 1.04–1.65; p = 0.024) and skull fracture (aOR 1.62, 95% CI 1.15–2.27; p = 0.006).

Conclusion

The proportion of diaper change-related falls among ED visits for falls in children aged 0 to < 3 years is increasing, particularly at home, and are associated with greater injury severity and risk of head trauma. Targeted caregiver education and national safety standards for diaper-changing equipment are needed to prevent these injuries.

Trial registration

Clinical trial number: Not applicable.