[Falls in less than one year-old infants: Management in the emergency department]

Abstract

Objectives: A study was performed in order to describe injuries associated with falls in children aged <1 year who attended the emergency department. The approaches used were examined, as well as the factors associated with the greater use of these approaches, and the management of the patient.

Patients and methods: This was a multicentre, descriptive and analytical study that included all patients aged <1 year who had experienced a fall for which they attended the emergency departments of one of 8 Spanish Hospitals belonging to the "Unintentional Paediatric Injury Working Group" of the Spanish Paediatric Society. A record was made of the data regarding the visit, circumstances before arrival at the hospital, injuries observed, and the diagnostic and therapeutic approaches used.

Results: A total of 1022 patients had experienced falls, that is, 0.35% of the emergencies attended in the study hospitals (95% CI, 0,348-0,352). The most commonly affected part was the head (58%). Cranial radiography was ordered in 31.8% of cases, and was associated with the presence of bruising or signs of fracture on examination (P<.001), falls from heights >100cm (P<.001), and age <3 months (P=.004). Minor head injury was the most common finding (85.6%), followed by fractures, especially cranial fractures (7.1%), which were associated with bruising or signs of fracture on examination (P<.001), and age <3 months (P<.001). Six percent of the patients required admission to hospital. The risk factors for hospital admission in this group were falls from heights >50cm and age <3 months.

Conclusions: Injuries after falls in infants aged <1 year are commonly due to head trauma and frequently require additional diagnostic tests.

Keywords: Caídas; Children; Diagnostic tests; Emergency department; Falls; Niños; Pruebas complementarias; Radiografías; Radiography; Urgencias.