Clinical characteristics and outcomes of children with injuries resulting from high falls: analysis of 138 cases

Di-san junyi daxue xuebao

DONG Zhan¹  JIANG Li¹  SUN Xiangshui¹ 

[1] Department of Pediatric Orthopedics, Children's Hospital of Nanjing Medical University, Nanjing, Jiangsu Province, 210000, China;

关键词: children;    high falls;    epidemiology;    injury;    treatment;   

DOI  :  10.16016/j.1000-5404.201907057

来源: DOAJ

【 摘 要 】

Objective To summarize the epidemiological and clinical characteristics of children with high fall injuries to improve the treatment and outcomes of the patients. Methods We retrospectively collected the clinical data from 138 children who had fall injuries (≥2 m) between January, 2012 and June, 2019. The patients consisted of 83 boys and 55 girls aged 1-14 years (mean 4.8 years), including 1 infant (≤1 year old), 24 toddlers (>1-3 years old), 74 preschoolers (>3-7 years old), and 39 schoolers (>7-14 years old). We analyzed the scenes of the falls, first aid measures before admission, treatments after admission, Injury Severity Scale (ISS) scores, height of falls and injury sites in all the cases. Results The children had injuries resulting from falls from windows or balconies (93 cases), motor vehicles (13 cases), stairs (11 cases), high platform (6 cases), guardrail (2 cases), roof or ceiling (2 cases), amusement facilities (1 case), and unknown places (10 cases). The heights of the falls were >2-3 m in 45 cases, >3-15 m in 83 cases, and >15 m in 10 cases. Forty-five children received surgical treatment and 93 had symptomatic treatment. The ISS score ≤16 in 46 cases, >16-25 in 76 cases and over 25 in 16 cases. The median length of hospital stay was 5 d (range 1-15 d). Thirty-nine of the children were admitted to ICU with a median ICU time of 5 d (range 3-10 d). Of all the children, 123 were discharged with cure or improvement; 15 of the children were not cured, among which 7 died, 4 had diffuse brain swelling and 4 had cerebral hernia. In the overall cases, high falls involved most frequently windows and balconies with a height of 3-15 m, which had a high likeliness of causing brain and chest injuries. There was no significant difference in the proportion of specific injury sites among the children with different fall heights (>2-3 m, >3-15 m and >15 m) and with different ISS scores (≤16, >16-25 and > 25) (P>0.05). A higher height of the fall was associated with a higher ISS score and a worse prognosis (P < 0.05). Conclusion For children, high falls often occur in windows and balconies, and falls from motor vehicles tend to increase. A comprehensive inspection of multiple parts and systems of the children should be carried out after high fall injuries; a falling height ≥3 m and an ISS score > 25 are both associated with a poor prognosis and a high mortality.

【 授权许可】

Unknown