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JOURNAL ARTICLE
RESEARCH SUPPORT, NON-U.S. GOV'T
A Novel Approach to Assessing Head Injury Severity in Pediatric Patient Falls.
Journal of Pediatric Health Care 2018 March
INTRODUCTION: Pediatric patient falls with head-to-floor impact have the greatest potential for injury.
METHODS: An objective measure of head injury severity, the Head Injury Criterion (HIC15 ), was calculated from anthropometric and biomechanical components of patient falls. A secondary aim was to compare HIC15 levels with the hospital's subjective assignment of level of harm (1-9 scale) used for regulatory reports.
RESULTS: Adverse event reports yielded a sample of 49 falls from heights of 72.5 to 1793.0 cm by children ages 11 months through 17 years. Contact velocity from beginning to end was 2.81 to 6.16 ms. Mean acceleration was 19.5 to 95.3g. HIC15 levels of impact ranged from 26.4 to 1,330.0, and mean force upon contact was 2.0 to 9.8 N/kg body mass. Seven (14.3%) children's HIC15 levels exceeded age-specific thresholds, with no follow-up scheduled. Hospital-assigned levels of harm were not correlated with HIC15 levels (r = .23, R2 = .05, p = .12).
DISCUSSION: A point-of-care computerized HIC15 algorithm would be useful for diagnostic and follow-up decisions.
METHODS: An objective measure of head injury severity, the Head Injury Criterion (HIC15 ), was calculated from anthropometric and biomechanical components of patient falls. A secondary aim was to compare HIC15 levels with the hospital's subjective assignment of level of harm (1-9 scale) used for regulatory reports.
RESULTS: Adverse event reports yielded a sample of 49 falls from heights of 72.5 to 1793.0 cm by children ages 11 months through 17 years. Contact velocity from beginning to end was 2.81 to 6.16 ms. Mean acceleration was 19.5 to 95.3g. HIC15 levels of impact ranged from 26.4 to 1,330.0, and mean force upon contact was 2.0 to 9.8 N/kg body mass. Seven (14.3%) children's HIC15 levels exceeded age-specific thresholds, with no follow-up scheduled. Hospital-assigned levels of harm were not correlated with HIC15 levels (r = .23, R2 = .05, p = .12).
DISCUSSION: A point-of-care computerized HIC15 algorithm would be useful for diagnostic and follow-up decisions.
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