• Shlok Patel, Riya Sawhney, Debojit Basak, Priyansh Nathani, Shamita Chatterjee, VeetilDeepa KizhakkeDKMax Institute of GI, Laparoscopy, Robotic and Bariatric Surgery, Max Super Speciality Hospital, Dwarka, Delhi, India., Nobhojit Roy, WärnbergMartin GerdinMGDepartment of Global Public Health, Karolinska Institute 17177, Stockholm, Sweden; Function Perioperative Medicine and Intensive Care, Karolinska University Hospital, Stockholm, Sweden., and Santosh Rath.
• World Health Organization Collaborating Centre for Emergency, Critical and Operative Care, Program for Global Surgery & Trauma, The George Institute of Global Health, New Delhi, India; Department of Orthopaedics, BJ Medical College, Ahmedabad, Gujarat, India.
• Injury. 2025 Feb 1; 56 (2): 112153112153.

BackgroundFalls are some of the most common childhood injuries. However, for vulnerable children in low- and middle-income countries (LMICs) such as India, mortality from a fall is nearly three times that of high-income countries. Despite fall being a leading cause of paediatric injury, detailed data from LMICs remain sparse. This study aims to assess fall-related patterns of injury and mortality in children in urban India.MethodsWe conducted a retrospective analysis from the Towards Improved Trauma Care Outcomes (TITCO) database, comprising 16,000 trauma patients admitted to four tertiary centres in India, between July 2013 and December 2015. We analysed demographics, Glasgow Coma Scale (GCS) score, Injury Severity Score (ISS), and the pattern of injury sustained for patients under 18-years admitted with fall and assessed survival probability in different age groups using Kaplan-Meier survival analysis and log-rank tests.ResultsOf 1281 children admitted after a fall, two-to-five-year-olds formed the majority (40 %). Nearly all children (99 %) had blunt trauma. The median ISS was 9 (IQR 9-11) and median GCS was 15. Overall in-hospital mortality was 7.8 % and isolated traumatic brain injury (TBI) was the most common (71 %) injury in those who died. Mortality was significantly higher in male children (9 %) than in female children (5 %) (p = 0.009). There was no significant difference in survival between age groups (p = 0.9).ConclusionThe majority of paediatric patients admitted to urban hospitals in India after a fall were between the ages of two-to-five years, with isolated TBI and male sex associated with greater mortality. These findings have the potential to aid age-specific fall prevention strategies and resource allocation towards targeted initiatives to improve access to care, and consequently, mortality from fall in urban India.Copyright © 2025 The Author(s). Published by Elsevier Ltd.. All rights reserved.

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