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001-es BibID:	BIBFORM112524
035-os BibID:	(Scopus)84945454313 (WOS)000364250900009
Első szerző:	Burrows, P.
Cím:	Head injury from falls in children younger than 6 years of age / P. Burrows, L. Trefan, R. Houston, J. Hughes, G. Pearson, R. J. Edwards, P. Hyde, I. Maconochie, R. C. Parslow, A. M. Kemp
Dátum:	2015
ISSN:	0003-9888
Megjegyzések:	ABSTRACT The risk of serious head injury (HI) from a fall in a young child is ill defined. The relationship between the object fallen from and prevalence of intracranial injury (ICI) or skull fracture is described. Method Cross-sectional study of HIs from falls in children (<6 years) admitted to UK hospitals, analysed according to the object fallen from and associated Glasgow Coma Score (GCS) or alert, voice, pain, unresponsive (AVPU) and CT scan results. Results Of 1775 cases ascertained (median age 18 months, 54.7% boys), 87% (1552) had a GCS=15/ AVPU=alert. 19.3% (342) had a CT scan: 32% (110/342) were abnormal; equivalent to 5.9% of the overall population, 16.9% (58) had isolated skull fractures and 13.7% (47) had ICI (49% (23/47) had an associated skull fracture). The prevalence of ICI increased with neurological compromise; however, 12% of children with a GCS=15/ AVPU=alert had ICI. When compared to falls from standing, falls from a person's arms (233 children (mean age 1 year)) had a significant relative OR for a skull fracture/ICI of 6.94 (95% CI 3.54 to 13.6), falls from a building (eg, window or attic) (mean age 3 years) OR 6.84 (95% CI 2.65 to 17.6) and from an infant or child product (mean age 21 months) OR 2.75 (95% CI 1.36 to 5.65). Conclusions Most HIs from a fall in these children admitted to hospital were minor. Infants, dropped from a carer's arms, those who fell from infant products, a window, wall or from an attic had the greatest chance of ICI or skull fracture. These data inform prevention and the assessment of the likelihood of serious injury when the object fallen from is known.
Tárgyszavak:	Orvostudományok Egészségtudományok idegen nyelvű folyóiratközlemény külföldi lapban folyóiratcikk
Megjelenés:	Archives Of Disease In Childhood. - 100 : 11 (2015), p. 1032-1037. -
További szerzők:	Trefán László (1969-) (biostatisztikus, bioinformatikus) Houston, R. Hughes, Jane Pearson, G. Edwards, R. Hyde, P. Maconochie, I. Parslow, R. C. Kemp, A.
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001-es BibID:	BIBFORM125959
035-os BibID:	(Scopus)84978976574 (WoS)000384069600011
Első szerző:	Kemp, Alison M.
Cím:	Selecting children for head CT following head injury / A. Kemp, E. Nickerson, L. Trefan, R. Houston, P. Hyde, G. Pearson, R. Edwards, R. C. Parslow, I. Maconochie
Dátum:	2016
ISSN:	0003-9888
Megjegyzések:	Objective Indicators for head CT scan defined by the 2007 National Institute for Health and Care Excellence (NICE) guidelines were analysed to identify CT uptake, influential variables and yield. Design Cross-sectional study. Setting Hospital inpatient units: England, Wales, Northern Ireland and the Channel Islands. Patients Children (<15 years) admitted to hospital for more than 4 h following a head injury (September 2009 to February 2010). Interventions CT scan. Main outcome measures Number of children who had CT, extent to which NICE guidelines were followed and diagnostic yield. Results Data on 5700 children were returned by 90% of eligible hospitals, 84% of whom were admitted to a general hospital. CT scans were performed on 30.4% of children (1734), with a higher diagnostic yield in infants (56.5% (144/255)) than children aged 1 to 14 years (26.5% (391/1476)). Overall, only 40.4% (984 of 2437 children) fulfilling at least one of the four NICE criteria for CT actually underwent one. These children were much less likely to receive CT if admitted to a general hospital than to a specialist centre (OR 0.52 (95% CI 0.45 to 0.59)); there was considerable variation between healthcare regions. When indicated, children >3 years were much more likely to have CT than those <3 years (OR 2.35 (95% CI 2.08 to 2.65)). Conclusion Compliance with guidelines and diagnostic yield was variable across age groups, the type of hospital and region where children were admitted. With this pattern of clinical practice the risks of both missing intracranial injury and overuse of CT are considerable.
Tárgyszavak:	Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban folyóiratcikk CT head injury cross-sectional study
Megjelenés:	Archives Of Disease In Childhood. - 101 : 10 (2016), p. 929-934. -
További szerzők:	Nickerson, E. Trefán László (1969-) (biostatisztikus, bioinformatikus) Houston, R. Hyde, P. Pearson, G. Edwards, R. Parslow, R. C. Maconochie, I.
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001-es BibID:	BIBFORM112521
035-os BibID:	(Scopus)84961784537 (WOS)000376936900007
Első szerző:	Trefán László (biostatisztikus, bioinformatikus)
Cím:	Epidemiology of children with head injury : a national overview / L. Trefan, R. Houston, G. Pearson, R. Edwards, P. Hyde, I. Maconochie, R. C. Parslow, A. Kemp
Dátum:	2016
ISSN:	0003-9888
Megjegyzések:	Background The National Confidential Enquiry describes the epidemiology of children admitted to hospital with head injury. Method Children (<15 years old) who died or were admitted for >4 h with head injury were identified from 216 UK hospitals (1 September 2009 to 28 February 2010). Data were collected using standard proformas and entered on to a database. A descriptive analysis of the causal mechanisms, child demographics, neurological impairment, CT findings, and outcome at 72 h are provided. Results Details of 5700 children, median age 4 years (range 0?14.9 years), were analysed; 1093 (19.2%) were <1 year old, 3500 (61.4%) were boys. There was a significant association of head injury with social deprivation 39.7/100 000 (95% CI 37.0 to 42.6) in the least deprived first quintile vs. 55.1 (95% CI 52.1 to 58.2) in the most deprived fifth quintile (p<0.01). Twenty-four children died (0.4%). Most children were admitted for one night or less; 4522 (79%) had a Glasgow Coma Scale score of 15 or were Alert (on AVPU (Alert, Voice, Pain, Unresponsive)). The most common causes of head injury were falls (3537 (62.1%); children <5 years), sports-related incidents (783 (13.7%); median age 12.4 years), or motor vehicle accidents (MVAs) (401 (7.1%); primary-school-aged children). CT scans were performed in 1734 (30.4%) children; 536 (30.9%) were abnormal (skull fracture and/or intracranial injury or abnormality): 269 (7.6%) were falls, 82 (10.5%) sports related and 100 (25%). A total of 357 (6.2%) children were referred to social care because of child protection concerns (median age 9 months (range 0?14.9 years)). Conclusions The data described highlight priorities for targeted age-specific head injury prevention and have the potential to provide a baseline to evaluate the effects of regional trauma networks (2012) and National Institute of Health and Care Excellence (NICE) head injury guidelines (2014), which were revised after the study was completed.
Tárgyszavak:	Orvostudományok Egészségtudományok idegen nyelvű folyóiratközlemény külföldi lapban folyóiratcikk közegészségtan
Megjelenés:	Archives Of Disease In Childhood. - 101 : 6 (2016), p. 527-532. -
További szerzők:	Houston, R. Pearson, G. Edwards, R. Hyde, P. Maconochie, I. Parslow, R. C. Kemp, A.
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