Defenestration in children younger than 6 years old: mortality predictors in severe head trauma
Purpose This study aims to describe the characteristics of severe head injuries in children less than 6 years old, victims of falls from windows, and identify the main predictive factors of mortality in this population. Patients and methods A cross-sectional study was designed through data derived f...
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| Veröffentlicht in: | Child's nervous system 2009-09, Vol.25 (9), p.1077-1083 |
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| creator | Melo, Jose Roberto Tude Di Rocco, Federico Lemos-Júnior, Laudenor Pereira Roujeau, Thomas Thélot, Bertrand Sainte-Rose, Christian Meyer, Philippe Zerah, Michel |
| description | Purpose This study aims to describe the characteristics of severe head injuries in children less than 6 years old, victims of falls from windows, and identify the main predictive factors of mortality in this population. Patients and methods A cross-sectional study was designed through data derived from medical records of less than 6-year-old children victims of falls from windows presenting with a severe head injury defined by an initial Glasgow coma scale (GCS) |
| doi_str_mv | 10.1007/s00381-009-0924-5 |
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| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_754891977</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>754891977</sourcerecordid><originalsourceid>FETCH-LOGICAL-c398t-758e0a36521445703e2437d9a617593fbe7d7e3a05688d9a38815c82c199ab3b3</originalsourceid><addsrcrecordid>eNp9kE1r3DAQhkVpSTZpfkAvrU7Nyc3I47Gk3kL6CYEc2pyF1h5nHWxrK9mF_ffV4oXechqYed4X5hHinYJPCkDfJAA0qgCwBdiyKuiV2KgKsQAkeC02UFJdaKjgXFyk9AygyJT2TJwrS6TQ2I1wX7jjidMc_dyHSfaTbHb90Eae5CEs0xNHOe_8JGt5YB-TDEP7WY4hzn7o54PcR277Zg75kqOJ_3JkuWPfyty4jP6teNP5IfHVaV6Kx29ff9_9KO4fvv-8u70vGrRmLjQZBo81laqqSANyWaFura-VJovdlnWrGT1QbUxeozGKGlM2ylq_xS1eiuu1dx_DnyX_48Y-NTwMfuKwJKepMlZZrTP58UWy1pSFksmgWsEmhpQid24f-9HHg1Pgjv7d6t9l3B39O8qZ96fyZTty-z9xEp6BcgVSPh3tuuewxCmrebH1wxrqfHD-KfbJPf4qQSGomoxBjf8A3JiY1Q</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>67500958</pqid></control><display><type>article</type><title>Defenestration in children younger than 6 years old: mortality predictors in severe head trauma</title><source>MEDLINE</source><source>SpringerLink Journals - AutoHoldings</source><creator>Melo, Jose Roberto Tude ; Di Rocco, Federico ; Lemos-Júnior, Laudenor Pereira ; Roujeau, Thomas ; Thélot, Bertrand ; Sainte-Rose, Christian ; Meyer, Philippe ; Zerah, Michel</creator><creatorcontrib>Melo, Jose Roberto Tude ; Di Rocco, Federico ; Lemos-Júnior, Laudenor Pereira ; Roujeau, Thomas ; Thélot, Bertrand ; Sainte-Rose, Christian ; Meyer, Philippe ; Zerah, Michel</creatorcontrib><description>Purpose This study aims to describe the characteristics of severe head injuries in children less than 6 years old, victims of falls from windows, and identify the main predictive factors of mortality in this population. Patients and methods A cross-sectional study was designed through data derived from medical records of less than 6-year-old children victims of falls from windows presenting with a severe head injury defined by an initial Glasgow coma scale (GCS) <=8, hospitalized at a Pediatric Trauma center level III, between January 2000 and December 2005. Statistical analysis used univariate analysis and multiple logistic regressions. Results We identified 58 severe head injuries in children victims of falls from windows. The mean age was 2.8 ± 1.4 years, with a male prevalence (64%); 48% of patients had a GCS <=5; 62.1% had a Pediatric Trauma Score (PTS) <=3 at hospital admission. The mortality rate was 41% (24/58) and most of them (88%; 21/24) died within 48 h. An increased death rate was noted in children admitted with hypoxemia (p = 0.001), low systolic blood pressure (p = 0.002), hypothermia (p = 0.0001), GCS <=5 (p = 10⁻⁵), PTS <=3 (p = 0.008), hyperglycemia (p = 0.023), coagulation disorders (p = 0.02), and initial intracranial pressure >=20 mmHg (p = 0.03). Initial hypothermia, hyperglycemia, and coagulation disorders were the only independent predictive factors of mortality. Conclusion Severe head injuries resulting from falls from windows carry a high risk of mortality in less than 6-year-old children. Hypothermia, hyperglycemia, and coagulation's disorders are independent predictive factors of mortality. Early deaths could be considered as direct consequences of uncontrollable brain lesions.</description><identifier>ISSN: 0256-7040</identifier><identifier>EISSN: 1433-0350</identifier><identifier>DOI: 10.1007/s00381-009-0924-5</identifier><identifier>PMID: 19551389</identifier><language>eng</language><publisher>Berlin/Heidelberg: Berlin/Heidelberg : Springer-Verlag</publisher><subject>Accidental Falls ; Analysis of Variance ; Blood Coagulation Disorders - epidemiology ; Child ; Child, Preschool ; Craniocerebral Trauma - epidemiology ; Craniocerebral Trauma - etiology ; Craniocerebral Trauma - mortality ; Cross-Sectional Studies ; Female ; Humans ; Hyperglycemia - epidemiology ; Hypothermia - epidemiology ; Infant ; Infant, Newborn ; Logistic Models ; Male ; Medicine ; Medicine & Public Health ; Neurosciences ; Neurosurgery ; Original Paper ; Prevalence ; Prognosis ; Retrospective Studies ; Severity of Illness Index ; Time Factors</subject><ispartof>Child's nervous system, 2009-09, Vol.25 (9), p.1077-1083</ispartof><rights>Springer-Verlag 2009</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c398t-758e0a36521445703e2437d9a617593fbe7d7e3a05688d9a38815c82c199ab3b3</citedby><cites>FETCH-LOGICAL-c398t-758e0a36521445703e2437d9a617593fbe7d7e3a05688d9a38815c82c199ab3b3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00381-009-0924-5$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00381-009-0924-5$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,780,784,27922,27923,41486,42555,51317</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/19551389$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Melo, Jose Roberto Tude</creatorcontrib><creatorcontrib>Di Rocco, Federico</creatorcontrib><creatorcontrib>Lemos-Júnior, Laudenor Pereira</creatorcontrib><creatorcontrib>Roujeau, Thomas</creatorcontrib><creatorcontrib>Thélot, Bertrand</creatorcontrib><creatorcontrib>Sainte-Rose, Christian</creatorcontrib><creatorcontrib>Meyer, Philippe</creatorcontrib><creatorcontrib>Zerah, Michel</creatorcontrib><title>Defenestration in children younger than 6 years old: mortality predictors in severe head trauma</title><title>Child's nervous system</title><addtitle>Childs Nerv Syst</addtitle><addtitle>Childs Nerv Syst</addtitle><description>Purpose This study aims to describe the characteristics of severe head injuries in children less than 6 years old, victims of falls from windows, and identify the main predictive factors of mortality in this population. Patients and methods A cross-sectional study was designed through data derived from medical records of less than 6-year-old children victims of falls from windows presenting with a severe head injury defined by an initial Glasgow coma scale (GCS) <=8, hospitalized at a Pediatric Trauma center level III, between January 2000 and December 2005. Statistical analysis used univariate analysis and multiple logistic regressions. Results We identified 58 severe head injuries in children victims of falls from windows. The mean age was 2.8 ± 1.4 years, with a male prevalence (64%); 48% of patients had a GCS <=5; 62.1% had a Pediatric Trauma Score (PTS) <=3 at hospital admission. The mortality rate was 41% (24/58) and most of them (88%; 21/24) died within 48 h. An increased death rate was noted in children admitted with hypoxemia (p = 0.001), low systolic blood pressure (p = 0.002), hypothermia (p = 0.0001), GCS <=5 (p = 10⁻⁵), PTS <=3 (p = 0.008), hyperglycemia (p = 0.023), coagulation disorders (p = 0.02), and initial intracranial pressure >=20 mmHg (p = 0.03). Initial hypothermia, hyperglycemia, and coagulation disorders were the only independent predictive factors of mortality. Conclusion Severe head injuries resulting from falls from windows carry a high risk of mortality in less than 6-year-old children. Hypothermia, hyperglycemia, and coagulation's disorders are independent predictive factors of mortality. Early deaths could be considered as direct consequences of uncontrollable brain lesions.</description><subject>Accidental Falls</subject><subject>Analysis of Variance</subject><subject>Blood Coagulation Disorders - epidemiology</subject><subject>Child</subject><subject>Child, Preschool</subject><subject>Craniocerebral Trauma - epidemiology</subject><subject>Craniocerebral Trauma - etiology</subject><subject>Craniocerebral Trauma - mortality</subject><subject>Cross-Sectional Studies</subject><subject>Female</subject><subject>Humans</subject><subject>Hyperglycemia - epidemiology</subject><subject>Hypothermia - epidemiology</subject><subject>Infant</subject><subject>Infant, Newborn</subject><subject>Logistic Models</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Neurosciences</subject><subject>Neurosurgery</subject><subject>Original Paper</subject><subject>Prevalence</subject><subject>Prognosis</subject><subject>Retrospective Studies</subject><subject>Severity of Illness Index</subject><subject>Time Factors</subject><issn>0256-7040</issn><issn>1433-0350</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2009</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kE1r3DAQhkVpSTZpfkAvrU7Nyc3I47Gk3kL6CYEc2pyF1h5nHWxrK9mF_ffV4oXechqYed4X5hHinYJPCkDfJAA0qgCwBdiyKuiV2KgKsQAkeC02UFJdaKjgXFyk9AygyJT2TJwrS6TQ2I1wX7jjidMc_dyHSfaTbHb90Eae5CEs0xNHOe_8JGt5YB-TDEP7WY4hzn7o54PcR277Zg75kqOJ_3JkuWPfyty4jP6teNP5IfHVaV6Kx29ff9_9KO4fvv-8u70vGrRmLjQZBo81laqqSANyWaFura-VJovdlnWrGT1QbUxeozGKGlM2ylq_xS1eiuu1dx_DnyX_48Y-NTwMfuKwJKepMlZZrTP58UWy1pSFksmgWsEmhpQid24f-9HHg1Pgjv7d6t9l3B39O8qZ96fyZTty-z9xEp6BcgVSPh3tuuewxCmrebH1wxrqfHD-KfbJPf4qQSGomoxBjf8A3JiY1Q</recordid><startdate>20090901</startdate><enddate>20090901</enddate><creator>Melo, Jose Roberto Tude</creator><creator>Di Rocco, Federico</creator><creator>Lemos-Júnior, Laudenor Pereira</creator><creator>Roujeau, Thomas</creator><creator>Thélot, Bertrand</creator><creator>Sainte-Rose, Christian</creator><creator>Meyer, Philippe</creator><creator>Zerah, Michel</creator><general>Berlin/Heidelberg : Springer-Verlag</general><general>Springer-Verlag</general><scope>FBQ</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>7TK</scope></search><sort><creationdate>20090901</creationdate><title>Defenestration in children younger than 6 years old: mortality predictors in severe head trauma</title><author>Melo, Jose Roberto Tude ; Di Rocco, Federico ; Lemos-Júnior, Laudenor Pereira ; Roujeau, Thomas ; Thélot, Bertrand ; Sainte-Rose, Christian ; Meyer, Philippe ; Zerah, Michel</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c398t-758e0a36521445703e2437d9a617593fbe7d7e3a05688d9a38815c82c199ab3b3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2009</creationdate><topic>Accidental Falls</topic><topic>Analysis of Variance</topic><topic>Blood Coagulation Disorders - epidemiology</topic><topic>Child</topic><topic>Child, Preschool</topic><topic>Craniocerebral Trauma - epidemiology</topic><topic>Craniocerebral Trauma - etiology</topic><topic>Craniocerebral Trauma - mortality</topic><topic>Cross-Sectional Studies</topic><topic>Female</topic><topic>Humans</topic><topic>Hyperglycemia - epidemiology</topic><topic>Hypothermia - epidemiology</topic><topic>Infant</topic><topic>Infant, Newborn</topic><topic>Logistic Models</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Neurosciences</topic><topic>Neurosurgery</topic><topic>Original Paper</topic><topic>Prevalence</topic><topic>Prognosis</topic><topic>Retrospective Studies</topic><topic>Severity of Illness Index</topic><topic>Time Factors</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Melo, Jose Roberto Tude</creatorcontrib><creatorcontrib>Di Rocco, Federico</creatorcontrib><creatorcontrib>Lemos-Júnior, Laudenor Pereira</creatorcontrib><creatorcontrib>Roujeau, Thomas</creatorcontrib><creatorcontrib>Thélot, Bertrand</creatorcontrib><creatorcontrib>Sainte-Rose, Christian</creatorcontrib><creatorcontrib>Meyer, Philippe</creatorcontrib><creatorcontrib>Zerah, Michel</creatorcontrib><collection>AGRIS</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>Neurosciences Abstracts</collection><jtitle>Child's nervous system</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Melo, Jose Roberto Tude</au><au>Di Rocco, Federico</au><au>Lemos-Júnior, Laudenor Pereira</au><au>Roujeau, Thomas</au><au>Thélot, Bertrand</au><au>Sainte-Rose, Christian</au><au>Meyer, Philippe</au><au>Zerah, Michel</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Defenestration in children younger than 6 years old: mortality predictors in severe head trauma</atitle><jtitle>Child's nervous system</jtitle><stitle>Childs Nerv Syst</stitle><addtitle>Childs Nerv Syst</addtitle><date>2009-09-01</date><risdate>2009</risdate><volume>25</volume><issue>9</issue><spage>1077</spage><epage>1083</epage><pages>1077-1083</pages><issn>0256-7040</issn><eissn>1433-0350</eissn><abstract>Purpose This study aims to describe the characteristics of severe head injuries in children less than 6 years old, victims of falls from windows, and identify the main predictive factors of mortality in this population. Patients and methods A cross-sectional study was designed through data derived from medical records of less than 6-year-old children victims of falls from windows presenting with a severe head injury defined by an initial Glasgow coma scale (GCS) <=8, hospitalized at a Pediatric Trauma center level III, between January 2000 and December 2005. Statistical analysis used univariate analysis and multiple logistic regressions. Results We identified 58 severe head injuries in children victims of falls from windows. The mean age was 2.8 ± 1.4 years, with a male prevalence (64%); 48% of patients had a GCS <=5; 62.1% had a Pediatric Trauma Score (PTS) <=3 at hospital admission. The mortality rate was 41% (24/58) and most of them (88%; 21/24) died within 48 h. An increased death rate was noted in children admitted with hypoxemia (p = 0.001), low systolic blood pressure (p = 0.002), hypothermia (p = 0.0001), GCS <=5 (p = 10⁻⁵), PTS <=3 (p = 0.008), hyperglycemia (p = 0.023), coagulation disorders (p = 0.02), and initial intracranial pressure >=20 mmHg (p = 0.03). Initial hypothermia, hyperglycemia, and coagulation disorders were the only independent predictive factors of mortality. Conclusion Severe head injuries resulting from falls from windows carry a high risk of mortality in less than 6-year-old children. Hypothermia, hyperglycemia, and coagulation's disorders are independent predictive factors of mortality. Early deaths could be considered as direct consequences of uncontrollable brain lesions.</abstract><cop>Berlin/Heidelberg</cop><pub>Berlin/Heidelberg : Springer-Verlag</pub><pmid>19551389</pmid><doi>10.1007/s00381-009-0924-5</doi><tpages>7</tpages></addata></record> |
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| subjects | Accidental Falls Analysis of Variance Blood Coagulation Disorders - epidemiology Child Child, Preschool Craniocerebral Trauma - epidemiology Craniocerebral Trauma - etiology Craniocerebral Trauma - mortality Cross-Sectional Studies Female Humans Hyperglycemia - epidemiology Hypothermia - epidemiology Infant Infant, Newborn Logistic Models Male Medicine Medicine & Public Health Neurosciences Neurosurgery Original Paper Prevalence Prognosis Retrospective Studies Severity of Illness Index Time Factors |
| title | Defenestration in children younger than 6 years old: mortality predictors in severe head trauma |
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