title: Head injury from falls in children younger than 6 years of age.
abstract: The risk of serious head injury (HI) from a fall in a young child is ill defined. The relationship between the object fallen from and prevalence of intracranial injury (ICI) or skull fracture is described.
  
  
  METHODS
  Cross-sectional study of HIs from falls in children (<6 years) admitted to UK hospitals, analysed according to the object fallen from and associated Glasgow Coma Score (GCS) or alert, voice, pain, unresponsive (AVPU) and CT scan results.
  
  
  RESULTS
  Of 1775 cases ascertained (median age 18 months, 54.7% boys), 87% (1552) had a GCS=15/AVPU=alert. 19.3% (342) had a CT scan: 32% (110/342) were abnormal; equivalent to 5.9% of the overall population, 16.9% (58) had isolated skull fractures and 13.7% (47) had ICI (49% (23/47) had an associated skull fracture). The prevalence of ICI increased with neurological compromise; however, 12% of children with a GCS=15/AVPU=alert had ICI. When compared to falls from standing, falls from a person's arms (233 children (mean age 1 year)) had a significant relative OR for a skull fracture/ICI of 6.94 (95% CI 3.54 to 13.6), falls from a building (eg, window or attic) (mean age 3 years) OR 6.84 (95% CI 2.65 to 17.6) and from an infant or child product (mean age 21 months) OR 2.75 (95% CI 1.36 to 5.65).
  
  
  CONCLUSIONS
  Most HIs from a fall in these children admitted to hospital were minor. Infants, dropped from a carer's arms, those who fell from infant products, a window, wall or from an attic had the greatest chance of ICI or skull fracture. These data inform prevention and the assessment of the likelihood of serious injury when the object fallen from is known.
authors: Institute of Primary Care and Public Health, Cardiff School of Medicine, Cardiff, Wales, UK.
authors: P
authors: P
authors: Burrows
authors: Institute of Primary Care and Public Health, Cardiff School of Medicine, Cardiff, Wales, UK.
authors: L
authors: L
authors: Trefan
authors: Placements Manager at Kids Company, London, UK.
authors: R
authors: R
authors: Houston
authors: Institute of Primary Care and Public Health, Cardiff School of Medicine, Cardiff, Wales, UK.
authors: J
authors: J
authors: Hughes
authors: Department of Anaesthesia and Intensive Care, University of Birmingham.
authors: G
authors: G
authors: Pearson
authors: Department of Neurosurgery, Bristol Hospital for Children, Bristol, UK.
authors: R J
authors: RJ
authors: Edwards
authors: Paediatric Intensive Care Unit, Southampton Childrens Hospital, Southampton, UK.
authors: P
authors: P
authors: Hyde
authors: National Institute for Health Research (NIHR) Biomedical Research Centre based at Imperial College Healthcare NHS Trust and Imperial College London.
authors: I
authors: I
authors: Maconochie
authors: Division of Epidemiology and Biostatistics, Leeds Institute of Genetics, Health and Therapeutics (LIGHT), University of Leeds, Leeds, UK.
authors: R C
authors: RC
authors: Parslow
authors: Institute of Primary Care and Public Health, Cardiff School of Medicine, Cardiff, Wales, UK.
authors: A M
authors: AM
authors: Kemp
mesh_terms: D000058:Accidental Falls / Q000706:statistics & numerical data*; D017677:Age Distribution; D001930:Brain Injuries / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000209:etiology; D002675:Child, Preschool; D006259:Craniocerebral Trauma / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000209:etiology; D003430:Cross-Sectional Studies; D005260:Female; D015600:Glasgow Coma Scale; D006801:Humans; D007223:Infant; D008297:Male; D012720:Severity of Illness Index; D012887:Skull Fractures / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000209:etiology; D014057:Tomography, X-Ray Computed; D006113:United Kingdom / Q000453:epidemiology
keywords: Accident & Emergency; Epidemiology; Injury Prevention