title: [Registry of mild craniocerebral trauma: multicentre study from the Spanish Association of Pediatric emergencies].
abstract: OBJECTIVE
  To determine management practices of minor head trauma in children evaluated at Spanish Hospital Emergency Departments and to determine patient variables associated with intracranial injury.
  
  
  METHODS
  Multicenter and prospective study during 18 months in 9 hospitals in Spain. Patients up to the age of 18 years with minor head trauma (Glasgow Coma Scale score higher than or equal to 13 on admission), treated in Emergency Departments and with a maximum onset of 72h since the traumatism, were included in the study.
  
  
  RESULTS
  A total of 1070 patients were studied with a median age of 2.4 years (p25-75 0.9-6.4 years); 61.2% were male. The median time between head trauma and medical consultation was 1 hour (p25-75 0.6-2.5h). Skull X-rays were performed on 64.5% of the children and a head CT scan on 9%; 91.4% of X-ray and 84.4% of CT were normal. The prevalence of intracranial injury was 1.4% (95% CI: 0.8-2.3). Twenty-five point three percent of the patients were admitted; 4 (3.7%) required neurosurgical intervention during admission. None of the patients died. Multiple logistic regression analysis identified loss of consciousness (OR 4.2, 95% CI: 1.1-17; P=0.045), neurological deterioration (OR 8.8, 95% CI: 2.1-37.6; P=0.003) and cephalhaematoma (OR 14.6, 95% CI: 4.9-44; P <0.001) as independent predictors of intracranial injury.
  
  
  CONCLUSIONS
  The combination of clinical parameters allows selection of patients with minor head trauma who need complementary explorations. In consequence, the routine use of skull X-ray in their initial evaluation is unnecessary.
authors.affiliation: Servicio de Urgencias de Pediatría, Hospital Sant Joan de Déu, Esplugues del Llobregat, Barcelona, España.
authors.forename: J J
authors.initials: JJ
authors.lastname: García García
authors.forename: I
authors.initials: I
authors.lastname: Manrique Martínez
authors.forename: V
authors.initials: V
authors.lastname: Trenchs Sainz de la Maza
authors.forename: A
authors.initials: A
authors.lastname: Suárez Suárez
authors.forename: L
authors.initials: L
authors.lastname: Martín de la Rosa
authors.forename: F J
authors.initials: FJ
authors.lastname: Travería Casanova
authors.forename: V
authors.initials: V
authors.lastname: Sebastián Barberan
authors.forename: E
authors.initials: E
authors.lastname: Crespo Rupérez
authors.forename: P J
authors.initials: PJ
authors.lastname: Alcalá Minagorre
authors.forename: A
authors.initials: A
authors.lastname: Canals Baeza
authors.forename: J
authors.initials: J
authors.lastname: Sitjes Costas
authors.forename: J
authors.initials: J
authors.lastname: Nadal Amat
authors.forename: C
authors.initials: C
authors.lastname: Luaces Cubells
mesh_terms: D000293:Adolescent; D001930:Brain Injuries / Q000453:epidemiology*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D015601:Injury Severity Score; D008297:Male; D011446:Prospective Studies; D012042:Registries; D013030:Spain