@article{ref1,
title="Defenestration in children younger than 6 years old: mortality predictors in severe head trauma",
journal="Child's nervous system",
year="2009",
author="Melo, Jose Roberto Tude and Di Rocco, Federico and Lemos-Júnior, Laudenor Pereira and Roujeau, Thomas and Thelot, Bertrand and Sainte-Rose, Christian and Meyer, P. and Zerah, Michel",
volume="25",
number="9",
pages="1077-1083",
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.<p /> <p>Language: en</p>",
language="en",
issn="0256-7040",
doi="10.1007/s00381-009-0924-5",
url="http://dx.doi.org/10.1007/s00381-009-0924-5"
}