Tarantino C A, Dowd M D, Murdock T C
Department of Pediatrics, The Children's Mercy Hospital, Kansas City, Missouri 64108, USA.
Pediatr Emerg Care. 1999 Feb;15(1):5-8. doi: 10.1097/00006565-199902000-00002.
To define injuries from short vertical falls (SVF) in infants, and to compare those with minor or no injuries to those with significant injury.
Descriptive, retrospective chart review.
Pediatric emergency department (PED) of an urban teaching hospital.
Infants < or = 10 months treated between January 1990 and December 1992 presenting with a SVF (< or = 4 feet).
167 patients met the definition. The mean age was 5.2 months; 56% were male. The mechanisms of injury included rolling off a bed (55%), being dropped from a caretaker's arms (20%), rolling off a couch (16%), and falling from other objects (10%). The majority of patients (85 %) had minor or no injury. Significant injuries were sustained by 15% (n = 25), including 16 with a closed head injury (12 with skull fractures), two with intracranial bleed, and seven with a long bone fracture. Subsequently, the two patients with intracranial hemorrhages were confirmed as being from child abuse. After excluding cases of suspected abuse, the only characteristic found to be independently associated with significant injury was being dropped by the caretaker (odds ratio: 6.4 vs rolling or falling from furniture, 95% CI: 2.0, 21.5).
The most common mechanism of a SVF was rolling off a bed. Most patients sustained minor or no injury. No child sustained an intracranial hemorrhage from a SVF. The child with intracranial injury and/or multiple injuries warrants an investigation. Being dropped appears to be a greater risk for significant injury than rolling off or falling from furniture.
明确婴儿短垂直距离坠落（SVF）所致损伤，并比较轻伤或无伤婴儿与重伤婴儿的情况。
描述性回顾性病历审查。
城市教学医院的儿科急诊科。
1990年1月至1992年12月间接受治疗的年龄≤10个月、发生SVF（≤4英尺）的婴儿。
167例患者符合定义。平均年龄为5.2个月；56%为男性。损伤机制包括从床上滚落（55%）、被看护人失手掉落（20%）、从沙发上滚落（16%）以及从其他物体上跌落（10%）。大多数患者（85%）受轻伤或无伤。15%（n = 25）的患者受重伤，包括16例闭合性颅脑损伤（12例颅骨骨折）、2例颅内出血和7例长骨骨折。随后，2例颅内出血患者被确认为受虐儿童。排除疑似虐待病例后，唯一被发现与重伤独立相关的特征是被看护人失手掉落（比值比：6.4，与从家具上滚落或跌落相比，95%可信区间：2.0, 21.5）。
SVF最常见的机制是从床上滚落。大多数患者受轻伤或无伤。没有儿童因SVF导致颅内出血。有颅内损伤和/或多处损伤的儿童需要进行调查。被看护人失手掉落似乎比从家具上滚落或跌落导致重伤的风险更大。
