• Brittany G Sullivan, Areg Grigorian, Michael Lekawa, Matthew O Dolich, Sebastian D Schubl, Cristobal Barrios, Victor C Joe, Boris Borazjani, and Jeffry Nahmias.
• From the Department of Surgery, University of California Irvine Medical Center, Orange, CA.
• Pediatr Emerg Care. 2022 May 1; 38 (5): e1262e1265e1262-e1265.

ObjectivesUp to 44% of pediatric traumatic brain injury occurs as a result of a fall. We hypothesized that a fall from height is associated with higher risk for subsequent midline shift in pediatric traumatic brain injury compared with a fall from same level.MethodsThe Pediatric Trauma Quality Improvement Program 2016 was queried for kids younger than 16 years with an injury in the abbreviated injury scale for the head after a fall. Patients with midline shift were identified. A logistic regression model was used for analysis.ResultsThe risk of a midline shift was lower in those with a fall from a height (odds ratio, 0.64; 95% confidence interval, 0.46-0.91, P = 0.01). In kids older than 4 years, there was no association between the level of height of the fall and subsequent midline shift (P = 0.62). The risk for midline shift in kids younger than 4 years after a fall from same level was lower (odds ratio, 0.40; 95% confidence interval, 0.24-0.67; P = 0.001).ConclusionsIn kids with traumatic brain injury, trauma activations due to falls from the same level are associated with a 2.5-fold higher risk of subsequent midline shift, compared with falling from height.Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.

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