Unintentional falls are a leading cause of morbidity and mortality in children and adolescents. Considering all pediatric trauma, falls account for the most common reason for an emergency department visit and are the fourth leading cause of trauma-related death, ranking behind motor vehicle accidents, fires, and drowning. 3,6,7,10 Overall, falls accounted for 5.9% of childhood deaths. 4 The injury patterns following a fall differ between children and adults. The proportionally greater cephalic

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... ass in children increases the likelihood of a fall-related head injury. 4 However, young children appear to suffer fewer extracranial injuries than adults when the fall occurs from the same height. 8, 11 To elucidate factors associated with head injury in pediatric fall victims, we undertook an analysis of pediatric falls at an institution in which these injuries are particularly common. CLINICAL MATERIAL AND METHODS The records of all fall victims treated at the Children's Hospital of Los Angeles over a seven-year period (1992-1998) were retrospectively reviewed. This hospital serves as the only American College of Surgeons--verified Pediatric Level I Trauma Center in Los Angeles County, serving 2.4 million children under 15 years of age and receiving approximately 25% of all pediatric trauma patients in the region. Cases were identified through the hospital's regional trauma database, and all cases satisfied either trauma activation criteria or were specifically triaged for trauma center evaluation. All patients were under 15 years of age and suffered a fall as the primary mechanism of blunt injury (however, patients who suffered a fall, for example, after being ejected as a result of a motor vehicle accident were excluded). Seven hundred eighty-four cases were identified, and complete records were available for 729 patients. International Classification of Diseases-9 codes, Injury Severity Score, GCS score, neuroimaging results, disposition, hospital length of stay, medical costs, and outcome were all Neurosurg Focus 8 (1):Article