Abstract
Background/Purpose: Falls are classified as low or high level for triage purposes. Because triage criteria dictate less urgency for low-level falls, this classification scheme has important implications for pediatric emergency care. Methods: Retrospective analysis was conducted of 729 (393 low-level and 336 high-level) pediatric patients treated for fall-related trauma (1992 through 1998). Falls were classified as low (<15 feet) or high-level (≥15 feet). All falls were reported as accidental or unintentional. Results: The overall mortality rate was 1.6% (2.4% for high-level falls compared with 1.0% for low-level falls). All 4 patients who died of a low-level fall had an abnormal head computed tomography (CT) scan and intracranial hypertension. Half of deaths from high-level falls were attributable to intracranial injuries, and half were caused by severe extracranial injuries. Common extracranial injuries were upper extremity fracture (6.2%), lower extremity fracture (5.6%), pulmonary contusion (1.8%), pneumothorax (1.1%), liver laceration (1.1%), bowel injury (1.0%), and splenic injury (2.1%). Orthopedic and thoracic injuries resulted more commonly from high-level falls, whereas abdominal injuries were as likely to occur after a low-level fall. Conclusions: Intracranial injury accounts for the majority of deaths from falls. Children suffering low-level falls were at similar risk for intracranial and abdominal injuries compared with those who fell from greater heights. Pediatric trauma triage criteria should account for these findings.
| Original language | English |
|---|---|
| Pages (from-to) | 1528-1534 |
| Number of pages | 7 |
| Journal | Journal of Pediatric Surgery |
| Volume | 36 |
| Issue number | 10 |
| DOIs | |
| State | Published - Oct 16 2001 |
| Externally published | Yes |
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Keywords
- Abdominal injury
- Fall
- Glasgow Coma Scale
- Head injury
- Trauma
ASJC Scopus subject areas
- Surgery
Cite this
Injuries from falls in the pediatric population : An analysis of 729 cases. / Wang, Michael Y.; Kim, K. Anthony; Griffith, Pamela M.; Summers, Susan; McComb, J. Gordon; Levy, Michael L.; Mahour, G. Hossein.
In: Journal of Pediatric Surgery, Vol. 36, No. 10, 16.10.2001, p. 1528-1534.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Injuries from falls in the pediatric population
T2 - An analysis of 729 cases
AU - Wang, Michael Y.
AU - Kim, K. Anthony
AU - Griffith, Pamela M.
AU - Summers, Susan
AU - McComb, J. Gordon
AU - Levy, Michael L.
AU - Mahour, G. Hossein
PY - 2001/10/16
Y1 - 2001/10/16
N2 - Background/Purpose: Falls are classified as low or high level for triage purposes. Because triage criteria dictate less urgency for low-level falls, this classification scheme has important implications for pediatric emergency care. Methods: Retrospective analysis was conducted of 729 (393 low-level and 336 high-level) pediatric patients treated for fall-related trauma (1992 through 1998). Falls were classified as low (<15 feet) or high-level (≥15 feet). All falls were reported as accidental or unintentional. Results: The overall mortality rate was 1.6% (2.4% for high-level falls compared with 1.0% for low-level falls). All 4 patients who died of a low-level fall had an abnormal head computed tomography (CT) scan and intracranial hypertension. Half of deaths from high-level falls were attributable to intracranial injuries, and half were caused by severe extracranial injuries. Common extracranial injuries were upper extremity fracture (6.2%), lower extremity fracture (5.6%), pulmonary contusion (1.8%), pneumothorax (1.1%), liver laceration (1.1%), bowel injury (1.0%), and splenic injury (2.1%). Orthopedic and thoracic injuries resulted more commonly from high-level falls, whereas abdominal injuries were as likely to occur after a low-level fall. Conclusions: Intracranial injury accounts for the majority of deaths from falls. Children suffering low-level falls were at similar risk for intracranial and abdominal injuries compared with those who fell from greater heights. Pediatric trauma triage criteria should account for these findings.
AB - Background/Purpose: Falls are classified as low or high level for triage purposes. Because triage criteria dictate less urgency for low-level falls, this classification scheme has important implications for pediatric emergency care. Methods: Retrospective analysis was conducted of 729 (393 low-level and 336 high-level) pediatric patients treated for fall-related trauma (1992 through 1998). Falls were classified as low (<15 feet) or high-level (≥15 feet). All falls were reported as accidental or unintentional. Results: The overall mortality rate was 1.6% (2.4% for high-level falls compared with 1.0% for low-level falls). All 4 patients who died of a low-level fall had an abnormal head computed tomography (CT) scan and intracranial hypertension. Half of deaths from high-level falls were attributable to intracranial injuries, and half were caused by severe extracranial injuries. Common extracranial injuries were upper extremity fracture (6.2%), lower extremity fracture (5.6%), pulmonary contusion (1.8%), pneumothorax (1.1%), liver laceration (1.1%), bowel injury (1.0%), and splenic injury (2.1%). Orthopedic and thoracic injuries resulted more commonly from high-level falls, whereas abdominal injuries were as likely to occur after a low-level fall. Conclusions: Intracranial injury accounts for the majority of deaths from falls. Children suffering low-level falls were at similar risk for intracranial and abdominal injuries compared with those who fell from greater heights. Pediatric trauma triage criteria should account for these findings.
KW - Abdominal injury
KW - Fall
KW - Glasgow Coma Scale
KW - Head injury
KW - Trauma
UR - http://www.scopus.com/inward/record.url?scp=0034816124&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=0034816124&partnerID=8YFLogxK
U2 - 10.1053/jpsu.2001.27037
DO - 10.1053/jpsu.2001.27037
M3 - Article
C2 - 11584402
AN - SCOPUS:0034816124
VL - 36
SP - 1528
EP - 1534
JO - Journal of Pediatric Surgery
JF - Journal of Pediatric Surgery
SN - 0022-3468
IS - 10
ER -