PT  - JOURNAL ARTICLE
AU  - G Paret
AU  - R Tirosh
AU  - D Lotan
AU  - M Stein
AU  - R Ben-Abraham
AU  - A Vardi
AU  - R Harel
AU  - Z Barzilay
TI  - Early prediction of neurological outcome after falls in children: metabolic and clinical markers.
AID  - 10.1136/emj.16.3.186
DP  - 1999 May 01
TA  - Journal of Accident & Emergency Medicine
PG  - 186--188
VI  - 16
IP  - 3
4099  - http://emj.bmj.com/content/16/3/186.short
4100  - http://emj.bmj.com/content/16/3/186.full
SO  - Arch Emerg Med1999 May 01; 16
AB  - Falls are the foremost reason for non-fatal injuries and are second only to motor vehicle accidents in causing accidental death. The purpose of this study was to identify the clinical and metabolic predictors of the outcome of head injury caused by falls from a height. Medical records of 61 children who had been admitted to the paediatric intensive care unit from 1990 to 1993 after falling from a height were reviewed retrospectively. Outcomes were categorised as good, moderate, severe, and poor. Glasgow coma scores, pupillary responses, brain oedema, and midline shift are significantly associated with poor outcome (p < 0.05). Metabolic markers associated with poor outcome included hyperglycaemia and hypokalaemia. Children with a poor outcome had, at admission, significantly higher glucose concentrations compared with children with good outcomes (mean SD): 20.0 (7.1) v 9.31 (4.0) mmol/l, p < 0.01), and lower potassium concentrations compared with children with good, moderate, and severe outcomes (mean (SD): 2.8 (0.4) v 3.7 (0.4) mmol/l, p < 0.001, 3.5 (0.3) mmol/l, p < 0.01, and 3.41 (0.3) mmol/l, p < 0.05, respectively). These findings allow for an early allocation of effort and resources to children injured from such falls.