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          "en" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Interventions and management in emergency department&#46;</p>"
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    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">Of all unintentional injuries&#44; falls constitute the most frequent reason for visiting paediatric emergency departments in the United States&#44; generating more than 2 million visits in patients aged less than 19 years in 2013&#46;<a class="elsevierStyleCrossRef" href="#bib0155"><span class="elsevierStyleSup">1</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">The injuries sustained in falls are among the main causes of death and permanent brain damage secondary to unintentional injuries&#46; The rate of mortality is highest in infants aged less than 1 year and adolescents&#44;<a class="elsevierStyleCrossRef" href="#bib0085"><span class="elsevierStyleSup">2</span></a> in who falls are associated with a large number of hospitalizations and a considerable economic and social burden&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">Despite the current recommendations of major research groups<a class="elsevierStyleCrossRef" href="#bib0090"><span class="elsevierStyleSup">3</span></a> that support watchful waiting in cases of mild fall-related injury&#44; the performance of diagnostic tests in the initial assessment of these patients continues to be a widespread practice in many paediatric emergency departments&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">The aim of our study was to describe and analyze fall-related injuries in infants aged less than 1 year&#44; their management in emergency departments&#44; the resources used in its management and the factors associated with an increased use of resources&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Materials and methods</span><p id="par0025" class="elsevierStylePara elsevierViewall">We conducted a substudy in the context of a larger study on the epidemiology and risk factors of fall-related injuries in infants aged less than 1 year&#46;<a class="elsevierStyleCrossRef" href="#bib0095"><span class="elsevierStyleSup">4</span></a></p><p id="par0030" class="elsevierStylePara elsevierViewall">It was a descriptive multicentre study&#46; We included infants aged less than 1 year that had sought care for a fall in the emergency departments of 8 hospitals members of the Working Group on Unintentional Injuries of the Sociedad Espa&#241;ola de Urgencias Pedi&#225;tricas &#40;Spanish Society of Paediatric Emergency Medicine&#41;&#44; between March 1&#44; 2014 and February 28&#44; 2015&#46;</p><p id="par0035" class="elsevierStylePara elsevierViewall">The study was approved by the ethics and clinical research committee of each participating hospital&#46;</p><p id="par0040" class="elsevierStylePara elsevierViewall">Fall is defined as the act or effect of falling until hitting ground or a firm surface that breaks the movement&#46;<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">5</span></a></p><p id="par0045" class="elsevierStylePara elsevierViewall">We collected data in a form that was filled out with the families of patients during their stay in the emergency department&#46; The data were entered in an electronic database &#40;Google Drive&#41; that could only be accessed by the principal investigator of the study&#46;</p><p id="par0050" class="elsevierStylePara elsevierViewall">We included epidemiological data &#40;age&#44; mechanism of the fall&#44; height of fall and whether the fall had been witnessed&#41;&#44; the circumstances of the arrival to the emergency department &#40;reason for visit&#44; mode of transport and time elapsed since fall&#41; and the management in the emergency department &#40;specialist that cared for patient&#44; type and location of injuries&#44; diagnostic tests&#44; interventions performed&#44; patient destination after discharge from department and final diagnosis&#41;&#46;</p><p id="par0055" class="elsevierStylePara elsevierViewall">The data were analyzed with the statistical software SPSS 18&#46;0&#46; We described quantitative variables as median and interquartile range &#40;IQR&#41;&#44; and qualitative variables as absolute and relative frequencies&#59; we made inferential analyses of qualitative variables using the <span class="elsevierStyleItalic">&#967;</span><span class="elsevierStyleSup">2</span> test&#44; using the Bonferroni adjustment for multiple comparisons&#46; In the latter case&#44; we have presented the overall <span class="elsevierStyleItalic">p</span>-values in the tables&#44; and specified in the text the <span class="elsevierStyleItalic">p</span>-values for each pair of categories for which the differences continued to be statistically significant after the correction&#46; We used the Student <span class="elsevierStyleItalic">t</span>-test for the analysis of quantitative variables&#46; We assessed for independent risk factors for the performance of diagnostic tests&#44; the presence of a skull fracture and the need for hospital admission by means of logistic regression&#46; We set the <span class="elsevierStyleItalic">p</span>-value for statistical significance at less than 0&#46;05&#46;</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Results</span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Before arrival to the emergency department</span><p id="par0060" class="elsevierStylePara elsevierViewall">During the period under study&#44; the participating hospitals received 289&#44;887 emergency visits&#44; and we identified 1022 patients aged less than 1 year that sought care for fall-related injuries&#44; which amounted to an incidence of 0&#46;35&#37; &#40;95&#37; CI&#44; 0&#46;348&#8211;0&#46;352&#37;&#41;&#46;</p><p id="par0065" class="elsevierStylePara elsevierViewall">An evaluation in the emergency department was sought directly by parents in 924 patients &#40;90&#46;4&#37;&#41;&#44; whereas 63 patients &#40;6&#46;1&#37;&#41; were referred from primary care&#44; 31 &#40;3&#37;&#41; transferred from another hospital&#44; and 4 &#40;0&#46;4&#37;&#41; arrived following a telephone consultation with the emergency department&#46;</p><p id="par0070" class="elsevierStylePara elsevierViewall">Most patients reached the emergency department in private vehicles &#40;968&#59; 94&#46;7&#37;&#41;&#44; followed by non-urgent ambulances &#40;36&#59; 3&#46;5&#37;&#41;&#44; urgent ambulances &#40;14&#59; 1&#46;3&#37;&#41; and public transportation &#40;4&#59; 0&#46;4&#37;&#41;&#46;</p><p id="par0075" class="elsevierStylePara elsevierViewall">The median time elapsed to arrival to the emergency department was 60<span class="elsevierStyleHsp" style=""></span>min &#40;IQR&#44; 60&#8211;180<span class="elsevierStyleHsp" style=""></span>min&#41;&#46; It is worth noting that the elapsed time was shorter in patients that had fallen from less than 1<span class="elsevierStyleHsp" style=""></span>m &#40;median&#44; 60<span class="elsevierStyleHsp" style=""></span>min&#41; compared to those that fell from more than 1<span class="elsevierStyleHsp" style=""></span>m &#40;median&#44; 90<span class="elsevierStyleHsp" style=""></span>min&#41;&#44; although the difference was not statistically significant &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;576&#41;&#46; Less time also elapsed for falls that had been witnessed &#40;median&#44; 60<span class="elsevierStyleHsp" style=""></span>min&#41; compared to falls that were not witnessed &#40;median&#44; 90<span class="elsevierStyleHsp" style=""></span>min&#41;&#44; a difference that was also not significant &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;152&#41;&#46;</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Data on emergency care</span><p id="par0080" class="elsevierStylePara elsevierViewall">Nine hundred and sixty-six children &#40;94&#46;5&#37;&#41; received care from a specialist&#46; Fifty-six cases &#40;5&#46;4&#37;&#41; required the collaborative assessment of several professionals&#44; with the most frequent consultations involving specialists in neurosurgery &#40;26&#59; 2&#46;5&#37;&#41; and traumatology &#40;17&#59; 1&#46;6&#37;&#41; &#40;<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0085" class="elsevierStylePara elsevierViewall">Traumatic injury was most frequently located in the head &#40;593&#59; 58&#37;&#41;&#46; The site of impact could not be determined in a considerable percentage of cases &#40;295&#59; 28&#46;9&#37;&#41;&#44; and 59 patients &#40;5&#46;8&#37;&#41; experienced trauma in more than one site&#46; Contusion and haematoma were the lesions detected most frequently &#40;633&#59; 61&#46;9&#37;&#41;&#44; followed by signs of fracture &#40;94&#59; 9&#46;1&#37;&#41;&#46; In 44 cases &#40;4&#46;3&#37;&#41; there was more than one type of injury&#44; mostly the combination of haematoma and signs of fracture &#40;23&#59; 2&#46;2&#37;&#41; &#40;<a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Emergency care outcomes</span><p id="par0090" class="elsevierStylePara elsevierViewall">Diagnostic tests were performed in 421 visits &#40;39&#46;2&#37;&#41;&#46;</p><p id="par0095" class="elsevierStylePara elsevierViewall">Skull radiographs were the most frequently ordered diagnostic test&#44; performed in as many as 31&#46;8&#37; of patients&#44; followed by head computed tomography &#40;CT&#41; in 7&#46;6&#37;&#44; long bone radiographs in 2&#46;2&#37; and transfontanellar ultrasound in 1&#46;2&#37;&#46; Blood or urine tests were ordered in 17 patients &#40;1&#46;6&#37;&#41; and radiographs of the chest or abdomen in 15 &#40;1&#46;5&#37;&#41;&#46; Sixty-two patients &#40;6&#37;&#41; underwent more than 1 diagnostic test&#44; most frequently a skull radiograph and a head CT scan &#40;in 38 patients&#41;&#46;</p><p id="par0100" class="elsevierStylePara elsevierViewall">We analyzed the performance of diagnostic tests based on the detection of injuries during physical examination&#44; the height of the fall&#44; the mechanism of the fall and whether the fall was or was not witnessed by a caregiver &#40;<a class="elsevierStyleCrossRefs" href="#tbl0015">Tables 3 and 4</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0015"></elsevierMultimedia><elsevierMultimedia ident="tbl0020"></elsevierMultimedia><p id="par0105" class="elsevierStylePara elsevierViewall">When it came to the mechanisms of falls&#44; we made an adjustment for multiple comparison using the Bonferroni method&#44; and found that skull radiographs were ordered less frequently for falls from standing compared to falls from infant equipment &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;031&#41;&#44; furniture &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;005&#41;&#44; a carer&#39;s arms &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;004&#41; and other mechanisms &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;045&#41;&#46; Computed tomography scans were requested more frequently for falls from a carer&#39;s arms compared to falls from infant equipment &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;001&#41;&#44; furniture &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;008&#41; and standing &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;003&#41;&#46;</p><p id="par0110" class="elsevierStylePara elsevierViewall">The multivariate analysis identified the presence of haematoma or signs of bone fracture in physical examination &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;001&#41;&#44; fall height &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;001&#41; and age &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;004&#41; as independent factors for performance of skull radiography&#44; while the statistical significance of fall height disappeared in the multivariate model&#46; When it came to performance of head CT&#44; the only identified risk factors were the presence of haematoma or signs of bone fracture in the physical examination &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;001&#41; and age less than 3 months &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;001&#41;&#46;</p><p id="par0115" class="elsevierStylePara elsevierViewall">Most patients had to stay under observation&#44; and 12&#46;2&#37; of them were discharged home directly from the emergency department &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>&#41;&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0120" class="elsevierStylePara elsevierViewall">Although mild head trauma was the most frequent diagnosis &#40;874&#59; 85&#46;6&#37;&#41;&#44; we ought to know that bone fracture was the second most frequent&#46; The most frequent fractures were skull fractures &#40;72&#59; 7&#37;&#41;&#44; followed by long bone fractures &#40;12&#59; 1&#46;1&#37;&#41; &#40;<a class="elsevierStyleCrossRef" href="#tbl0025">Table 5</a>&#41;&#46; The independent risk factors for skull fracture identified in our study were the presence of haematoma or signs of fracture in the physical examination &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;001&#41; and age less than 3 months &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;001&#41;&#44; while fall height was not significant &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;075&#41;&#46; Skull fractures were associated with falls from a carer&#39;s arms in the univariate analysis &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;001&#41;&#44; but were not a significant factor and therefore removed in the logistic regression model&#46;</p><elsevierMultimedia ident="tbl0025"></elsevierMultimedia><p id="par0125" class="elsevierStylePara elsevierViewall">Sixteen patients presented with intracranial haemorrhage &#40;1&#46;5&#37;&#41;&#44; of who half were younger than 3 months &#40;8&#59; 50&#37;&#41;&#44; and the risk of haemorrhage was significantly associated with age less than 3 months &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;001&#41;&#46; The analysis of patients that underwent CT did not find an association between the presence of intracranial haemorrhage and fall height &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;31&#41; or the mechanism of the fall &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;438&#41;&#46; We ought to note that 13 of the 16 episodes of haemorrhage occurred in patients with temporal or parietal bone fractures&#46;</p><p id="par0130" class="elsevierStylePara elsevierViewall">Hospital admission was required in 61 patients &#40;6&#37;&#41;&#44; and we identified fall height of more than 50<span class="elsevierStyleHsp" style=""></span>cm &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;001&#41; and age less than 3 months &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;001&#41; as risk factors for hospitalization&#46; Hospital admission was also more frequent in patients that fell from a carer&#39;s arms compared to falls from infant equipment &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;004&#41;&#44; although age less than 3 months and fall from a height of more than 50<span class="elsevierStyleHsp" style=""></span>cm were the only independent risk factors identified in the logistic regression analysis &#40;<a class="elsevierStyleCrossRef" href="#tbl0030">Table 6</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0030"></elsevierMultimedia><p id="par0135" class="elsevierStylePara elsevierViewall">Twenty-four patients &#40;39&#37;&#41; were hospitalised for more than 24<span class="elsevierStyleHsp" style=""></span>h&#44; and 8 required admission to an intensive care unit&#46; None of the patients died in the first 24<span class="elsevierStyleHsp" style=""></span>h following the fall&#46;</p></span></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">Discussion</span><p id="par0140" class="elsevierStylePara elsevierViewall">The findings of this study allow us to analyze the emergency management of infants aged less than 1 year that seek care following a fall in paediatric emergency departments&#44; and revealed a persisting tendency to perform skull radiographs and a moderate use of in-hospital resources in their management consisting of the performance of diagnostic tests&#44; observation in emergency department&#44; assessment by other specialists and admission to hospital&#46;</p><p id="par0145" class="elsevierStylePara elsevierViewall">In contrast&#44; the use of out-of-hospital resources was scarce&#44; as most patients sought care on the initiative of their parents and with their own resources&#44; with referral from other health care settings amounting to only 9&#46;5&#37; and ambulance transport to 4&#46;8&#37; of the total&#46; These findings were consistent with the results of a previous study conducted by the Sociedad de Urgencias Pedi&#225;tricas&#44; in which 96&#46;3&#37; of patients with mild head trauma reached the hospital through private means&#46;<a class="elsevierStyleCrossRef" href="#bib0105"><span class="elsevierStyleSup">6</span></a></p><p id="par0150" class="elsevierStylePara elsevierViewall">One salient finding was the promptness with which caregivers sought an evaluation in the emergency department&#44; with a median elapsed time since the fall of 1<span class="elsevierStyleHsp" style=""></span>h&#44; which has also been observed in previous studies&#46;<a class="elsevierStyleCrossRef" href="#bib0110"><span class="elsevierStyleSup">7</span></a> This may reflect an increased awareness of parents of the potential severity of fall-related injuries in this age group&#46; Nevertheless&#44; in our study we found that patients that fell from greater heights or whose falls were not witnessed&#44; with mechanisms with a significant potential for injury&#44; did not seek emergency care earlier&#46; We did not find data in the literature regarding these factors&#46;</p><p id="par0155" class="elsevierStylePara elsevierViewall">Kendrick et al&#46; also found no evidence that caregiver awareness of the potential for severe injury is associated with an increased use of preventive measures&#44; and observed that parents of patients that had fallen from furniture were less likely to use safety gates and left infants on raised surfaces more frequently&#46;<a class="elsevierStyleCrossRef" href="#bib0115"><span class="elsevierStyleSup">8</span></a></p><p id="par0160" class="elsevierStylePara elsevierViewall">Haney et al&#46;<a class="elsevierStyleCrossRef" href="#bib0120"><span class="elsevierStyleSup">9</span></a> also highlighted the absence of effective preventive measures&#44; as 40&#37; of children aged less than 2 years have experienced at least 1 previous fall from a height&#46;</p><p id="par0165" class="elsevierStylePara elsevierViewall">Paediatricians managed most patients&#44; although other specialists were consulted to assess the child in 6&#46;9&#37; of cases&#44; primarily in the area of neurosurgery &#40;26&#59; 2&#46;5&#37;&#41;&#46; We did not find any previous studies documenting the need for evaluation by other specialists in children that had experienced a fall&#46;</p><p id="par0170" class="elsevierStylePara elsevierViewall">The proportion of patients that underwent skull radiography and head CT was similar to those reported by some studies&#44;<a class="elsevierStyleCrossRefs" href="#bib0125"><span class="elsevierStyleSup">10&#8211;12</span></a> and slightly higher than that reported in others&#44; especially when it came to skull radiographs&#46;<a class="elsevierStyleCrossRef" href="#bib0140"><span class="elsevierStyleSup">13</span></a> These tests were ordered more frequently in patients that presented with haematoma or signs of fracture in the physical examination&#44; in those aged less than 3 months and&#44; in the case of skull radiographs&#44; in those who had fallen from heights of more than 1<span class="elsevierStyleHsp" style=""></span>m&#46; The univariate analysis also found an association with the mechanism of the fall&#44; but this probably does not reflect an actual relationship &#8211; as demonstrated by the results of logistic regression &#8211; but rather the association of both age and fall height with fall mechanism&#46; Garc&#237;a et al&#46; also found a more frequent use of skull radiographs in younger patients&#46;<a class="elsevierStyleCrossRef" href="#bib0105"><span class="elsevierStyleSup">6</span></a> We have not found works in the literature analysing the association of the use of diagnostic tests with fall height or fall mechanism&#46;</p><p id="par0175" class="elsevierStylePara elsevierViewall">In relation to this finding&#44; we ought to note that international guidelines and various studies are increasingly questioning the need for skull radiographs in the initial evaluation of patients with head trauma&#46; In spite of this&#44; it continues to be frequently used in emergency departments for the purpose of ruling out skull fracture&#44; which is significant risk factor for traumatic brain injury in infants&#46; However&#44; radiography has little predictive value in the detection of brain injuries compared to physical examination and clinical manifestations&#44; and there is evidence that intracranial injury may be present in patients with normal radiographic findings&#46;<a class="elsevierStyleCrossRef" href="#bib0145"><span class="elsevierStyleSup">14</span></a> Even when radiography detects intracranial injury&#44; only a small percentage of these patients requires neurosurgery&#46;<a class="elsevierStyleCrossRef" href="#bib0090"><span class="elsevierStyleSup">3</span></a></p><p id="par0180" class="elsevierStylePara elsevierViewall">Although most of the fall-related injuries in our series were mild&#44; we ought to note that fractures constituted the second most-frequent diagnosis&#44; most of them skull fractures and in infants aged less than 3 months&#44; with no association with the height of the fall&#46; The incidence of skull fractures was similar to those reported in previous studies&#44;<a class="elsevierStyleCrossRefs" href="#bib0105"><span class="elsevierStyleSup">6&#44;11&#44;13</span></a> although these works did not analyze the association between skull fracture and factors such as fall height&#44; patient age or mechanism of injury&#46;</p><p id="par0185" class="elsevierStylePara elsevierViewall">Our study found a total of 16 patients with intracranial haemorrhage &#40;1&#46;5&#37;&#41;&#44; and brain injury in 22&#37; of patients with skull fractures&#46; The percentage of brain injury associated with skull trauma reported by other authors is slightly higher&#44;<a class="elsevierStyleCrossRef" href="#bib0090"><span class="elsevierStyleSup">3</span></a> which may be due to the fact that our study only included patients with fall-related injuries&#44; excluding other mechanisms of injury such as motor vehicle accidents&#46; The frequency of intracranial injury observed in our series was similar to the frequencies reported in studies with similar sample frames&#46;<a class="elsevierStyleCrossRefs" href="#bib0130"><span class="elsevierStyleSup">11&#44;15</span></a></p><p id="par0190" class="elsevierStylePara elsevierViewall">Half of the patients presenting with intracranial haemorrhage were aged less than 3 years&#44; and age was identified as a significant risk factor&#46; Furthermore&#44; 11 of the 16 cases of haemorrhage occurred in patients with parietal bone fractures&#44; a type of skull fracture that was also significantly more frequent in this age group&#46; However&#44; there are other studies that have not found an increased risk of intracranial injury in children aged less than 2 years&#46;<a class="elsevierStyleCrossRef" href="#bib0105"><span class="elsevierStyleSup">6</span></a> One possible explanation is that the median age of the patients included in these other studies was greater&#44; and that the authors did not carry out age-stratified analyses in children aged less than 2 years&#46; We have not found any studies that included as many patients aged less than 3 months as ours&#46;</p><p id="par0195" class="elsevierStylePara elsevierViewall">In our series&#44; 14 patients &#40;1&#46;3&#37;&#41; presented with clinically significant injuries &#40;requiring neurosurgery&#44; intubation of more than 24<span class="elsevierStyleHsp" style=""></span>h&#44; hospitalization of more than 48<span class="elsevierStyleHsp" style=""></span>h&#44; admission to the PICU or haemodynamic stabilization&#41;&#59; none of them died&#46; Kupperman et al&#46;<a class="elsevierStyleCrossRef" href="#bib0090"><span class="elsevierStyleSup">3</span></a> reported a prevalence of 0&#46;9&#37;&#44; with an increased probability of clinically significant injury in the presence of certain prognostic variables&#46; Similar percentages have been reported for Spain at the national level&#46;<a class="elsevierStyleCrossRef" href="#bib0105"><span class="elsevierStyleSup">6</span></a></p><p id="par0200" class="elsevierStylePara elsevierViewall">On the other hand&#44; only 12&#46;2&#37; of patients managed for falls were discharged without undergoing any intervention&#44; while 86&#46;7&#37; required clinical observation and 2&#46;9&#37; some form of procedure &#40;major surgery&#44; suturing&#44; immobilization&#47;reduction or haemodynamic stabilization&#41;&#46;</p><p id="par0205" class="elsevierStylePara elsevierViewall">Furthermore&#44; 6&#37; &#40;61&#41; of the patients were hospitalised&#44; of which 8 were admitted to an intensive care unit&#46; There is variability in the percentages of hospitalization reported in the literature&#44; with some studies reported rates similar to those in our study&#44;<a class="elsevierStyleCrossRef" href="#bib0130"><span class="elsevierStyleSup">11</span></a> and others reporting higher<a class="elsevierStyleCrossRef" href="#bib0135"><span class="elsevierStyleSup">12</span></a> or lower<a class="elsevierStyleCrossRef" href="#bib0140"><span class="elsevierStyleSup">13</span></a> rates&#44; which may be due to differences in infrastructure and the availability of short-stay observation units&#46; The rate of admission to the PICU was similar to those reported by other authors&#46;<a class="elsevierStyleCrossRefs" href="#bib0105"><span class="elsevierStyleSup">6&#44;13</span></a></p><p id="par0210" class="elsevierStylePara elsevierViewall">The independent risk factors for hospital admission identified in our study were fall from height of more than 50<span class="elsevierStyleHsp" style=""></span>cm and age less than 3 years&#46; We did not find any studies in the reviewed literature analysing the association of these factors with the risk of hospitalization&#46;</p><p id="par0215" class="elsevierStylePara elsevierViewall">There are limitations to our study&#44; for instance&#44; that we did not consider the association between the clinical presentation and the ordering of diagnostic tests&#46; However&#44; the aim of our study was not to judge whether the use of diagnostic tests was appropriate&#44; but to describe and analyze the actual characteristics and management of fall-related injuries in emergency departments in Spain&#46; Other limitations include the variability that may stem from the different protocols at use in each hospital&#44; the potential for missing data on patients that did not seek emergency care due to the seeming mildness of the manifestations&#44; and the absence of a subsequent followup to analyze patient outcomes and detect events secondary to the fall that may have manifested at a later time&#46;</p><p id="par0220" class="elsevierStylePara elsevierViewall">Thus&#44; we found evidence that while fall-related injuries in infants aged less than 1 year are not usually severe&#44; they continue to be a frequent reason for the performance of diagnostic tests&#44; especially in infants aged less than 3 years and falls from greater heights&#46;</p><p id="par0225" class="elsevierStylePara elsevierViewall">Infants are usually kept under observation in the emergency department&#44; and a small proportion requires assessment by other specialists&#46; Age less than 3 months and falls from heights of more than 50<span class="elsevierStyleHsp" style=""></span>cm were independent risk factors for hospital admission&#44; and management of such cases was associated with an increased use of in-hospital resources&#46;</p><p id="par0230" class="elsevierStylePara elsevierViewall">Infants aged less than 3 months constitute a high-risk group&#44; with a significant incidence of secondary brain injury&#44; so emphasis must be placed on the importance of appropriate preventive measures&#44; striving to improve the knowledge of caregivers on potential fall mechanisms and the strategies that they can use to prevent them&#46;</p></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0100">Conflict of interests</span><p id="par0235" class="elsevierStylePara elsevierViewall">The authors have no conflict of interests to declare&#46;</p></span></span>"
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    "fechaRecibido" => "2016-06-28"
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            1 => "Children"
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        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Objectives</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">A study was performed in order to describe injuries associated with falls in children aged &#60;1 year who attended the emergency department&#46; The approaches used were examined&#44; as well as the factors associated with the greater use of these approaches&#44; and the management of the patient&#46;</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Patients and methods</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">This was a multicentre&#44; descriptive and analytical study that included all patients aged &#60;1 year who had experienced a fall for which they attended the emergency departments of one of 8 Spanish Hospitals belonging to the &#8220;Unintentional Paediatric Injury Working Group&#8221; of the Spanish Paediatric Society&#46; A record was made of the data regarding the visit&#44; circumstances before arrival at the hospital&#44; injuries observed&#44; and the diagnostic and therapeutic approaches used&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Results</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">A total of 1022 patients had experienced falls&#44; that is&#44; 0&#46;35&#37; of the emergencies attended in the study hospitals &#40;95&#37; CI&#44; 0&#46;348&#8211;0&#46;352&#41;&#46; The most commonly affected part was the head &#40;58&#37;&#41;&#46; Cranial radiography was ordered in 31&#46;8&#37; of cases&#44; and was associated with the presence of bruising or signs of fracture on examination &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;001&#41;&#44; falls from heights &#62;100<span class="elsevierStyleHsp" style=""></span>cm &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;001&#41;&#44; and age &#60;3 months &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;004&#41;&#46; Minor head injury was the most common finding &#40;85&#46;6&#37;&#41;&#44; followed by fractures&#44; especially cranial fractures &#40;7&#46;1&#37;&#41;&#44; which were associated with bruising or signs of fracture on examination &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;001&#41;&#44; and age &#60;3 months &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;001&#41;&#46; Six percent of the patients required admission to hospital&#46; The risk factors for hospital admission in this group were falls from heights &#62;50<span class="elsevierStyleHsp" style=""></span>cm and age &#60;3 months&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conclusions</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Injuries after falls in infants aged &#60;1 year are commonly due to head trauma and frequently require additional diagnostic tests&#46;</p></span>"
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        "resumen" => "<span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Objetivos</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Describir y analizar las lesiones asociadas a ca&#237;das en los menores de un a&#241;o&#44; la actuaci&#243;n durante su atenci&#243;n en urgencias&#44; los medios empleados en su manejo y los factores que condicionan un mayor uso de los mismos&#46;</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Material y m&#233;todos</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Estudio multic&#233;ntrico&#44; descriptivo y anal&#237;tico&#46; Se incluyeron los menores de un a&#241;o que hab&#237;an acudido por ca&#237;das al servicio de urgencias de 8 hospitales integrantes del Grupo de Trabajo de Lesiones no Intencionadas de la Sociedad Espa&#241;ola de Urgencias Pedi&#225;tricas&#46; Se recogieron datos sobre las circunstancias previas a la llegada a urgencias&#44; las lesiones observadas&#44; la actuaci&#243;n en urgencias y los medios empleados durante su manejo&#46;</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Resultados</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Se identificaron 1&#46;022 pacientes&#44; un 0&#44;35&#37; de las urgencias atendidas &#40;IC 95&#37;&#58; 0&#44;348&#8211;0&#44;352&#41;&#46; La localizaci&#243;n m&#225;s frecuente del traumatismo fue craneal &#40;58&#37;&#41;&#46; La indicaci&#243;n de radiograf&#237;a de cr&#225;neo &#40;31&#44;8&#37;&#41; se relacion&#243; con hematomas o signos de fractura en la exploraci&#243;n f&#237;sica &#40;p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41;&#44; alturas mayores de 100<span class="elsevierStyleHsp" style=""></span>cm &#40;p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41; y edad menor de 3 meses &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;004&#41;&#46; Tras el traumatismo craneal leve &#40;85&#44;6&#37;&#41;&#44; las fracturas fueron el diagn&#243;stico m&#225;s frecuente&#44; fundamentalmente craneales &#40;7&#44;1&#37;&#41;&#44; asoci&#225;ndose con una edad menor de 3 meses &#40;p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41; y con la existencia de haematoma o signos de fractura en la exploraci&#243;n f&#237;sica &#40;p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41;&#46; Un 6&#37; de los casos requirieron hospitalizaci&#243;n&#44; identific&#225;ndose la edad menor a 3 meses y una ca&#237;da mayor a 50<span class="elsevierStyleHsp" style=""></span>cm como factores de riesgo&#46;</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Conclusiones</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Las lesiones por ca&#237;das en los menores de un a&#241;o se producen fundamentalmente por traumatismos craneales y siguen constituyendo una indicaci&#243;n frecuente de realizaci&#243;n de pruebas complementarias&#46;</p></span>"
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        "nota" => "<p class="elsevierStyleNotepara" id="npar0025">Please cite this article as&#58; Rubio Garc&#237;a E&#44; Jim&#233;nez de Domingo A&#44; Mara&#241;on Pardillo R&#44; Trivi&#241;o Rodr&#237;guez M&#44; Frontado Haiek LA&#44; Gilabert Iriondo N&#44; et al&#46; Ca&#237;das en menores de un a&#241;o&#58; &#191;qu&#233; hacemos en urgencias&#63; An Pediatr &#40;Barc&#41;&#46; 2017&#59;87&#58;269&#8211;275&#46;</p>"
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        "nota" => "<p class="elsevierStyleNotepara" id="npar0030">Previous presentation&#58; This study was presented as an oral communication at the XX Annual Meeting of the Sociedad Espa&#241;ola de Urgencias de Pediatr&#237;a&#44; 2015&#44; Bilbao&#44; Spain&#46;</p>"
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                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Site&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Skull&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">593 &#40;58&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">None&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">295 &#40;28&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Face&#47;neck&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">151 &#40;14&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Upper extremities&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">14 &#40;1&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Lower extremities&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">13 &#40;1&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Back&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">5 &#40;0&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Shoulder girdle&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">5 &#40;0&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Thorax&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">4 &#40;0&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Pelvis&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2 &#40;0&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
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                0 => "xTab1576331.png"
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            1 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Type of injury&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">N</span> &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Contusion&#47;haematoma&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">633 &#40;61&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">None&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">341 &#40;33&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Open&#47;closed fracture&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">49 &#40;4&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Abrasion&#47;laceration&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">20 &#40;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Cut&#47;puncture wound&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">14 &#40;1&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Avulsion&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">6 &#40;0&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Corneal erosion&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">4 &#40;0&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Localized oedema and tumefaction&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1 &#40;0&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
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          "en" => "<p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">Site and type of injuries&#46;</p>"
        ]
      ]
      3 => array:8 [
        "identificador" => "tbl0015"
        "etiqueta" => "Table 3"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at3"
            "detalle" => "Table "
            "rol" => "short"
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        "tabla" => array:3 [
          "leyenda" => "<p id="spar0065" class="elsevierStyleSimplePara elsevierViewall">The table shows the overall <span class="elsevierStyleItalic">p</span>-value&#44; while the text specifies the particular <span class="elsevierStyleItalic">p</span>-value for comparisons of 2 categories that were significant&#46;</p><p id="spar0070" class="elsevierStyleSimplePara elsevierViewall">The category with a significantly lower frequency of skull radiograph ordering compared to other mechanisms is presented in boldface&#46;</p><p id="spar0075" class="elsevierStyleSimplePara elsevierViewall">PE&#44; physical examination&#46;</p>"
          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="left" valign="top" scope="col">Variable&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col">Rx&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col">No&#46; Rx&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col"><span class="elsevierStyleItalic">p</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr><tr title="table-row"><th class="td" title="table-head  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">N</span> &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">N</span> &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry  " colspan="4" align="left" valign="top"><span class="elsevierStyleItalic">Skull lesions on PE</span></td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>None&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">59 &#40;17&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">282 &#40;82&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Haematoma&#47;fracture&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">261 &#40;41&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">373 &#40;58&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#60;0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Other&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">4 &#40;18&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">18 &#40;81&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="4" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="4" align="left" valign="top"><span class="elsevierStyleItalic">Fall height</span><a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a></td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>&#60;100<span class="elsevierStyleHsp" style=""></span>cm&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">284 &#40;30&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">642 &#40;69&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>&#62;100<span class="elsevierStyleHsp" style=""></span>cm&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">39 &#40;42&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">53 &#40;57&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#46;021&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="4" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="4" align="left" valign="top"><span class="elsevierStyleItalic">Age</span></td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>&#60;3<span class="elsevierStyleHsp" style=""></span>meses&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">39 &#40;42&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">52 &#40;57&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>&#62;3<span class="elsevierStyleHsp" style=""></span>meses&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">286 &#40;30&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">645 &#40;69&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#60;0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="4" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="4" align="left" valign="top"><span class="elsevierStyleItalic">Fall mechanism</span><a class="elsevierStyleCrossRef" href="#tblfn0010"><span class="elsevierStyleSup">b</span></a></td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Infant equipment&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">221 &#40;31&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">488 &#40;68&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Furniture&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">20 &#40;42&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">27 &#40;57&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Carer&#39;s arms&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">36 &#40;40&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">54 &#40;60&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#46;029&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleBold">Standing height</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">10 &#40;17&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">47 &#40;82&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Other&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">38 &#40;32&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">81 &#40;68&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="4" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="4" align="left" valign="top"><span class="elsevierStyleItalic">Witnessing of fall</span></td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Witnessed&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">221 &#40;31&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">474 &#40;68&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#46;999&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Not witnessed&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">104 &#40;31&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">223 &#40;68&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
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          "notaPie" => array:2 [
            0 => array:3 [
              "identificador" => "tblfn0005"
              "etiqueta" => "a"
              "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Missing data in 4 patients for whom the height of the fall is unknown&#46;</p>"
            ]
            1 => array:3 [
              "identificador" => "tblfn0010"
              "etiqueta" => "b"
              "nota" => "<p class="elsevierStyleNotepara" id="npar0010">An adjustment for multiple comparisons was made for variables with more than 2 categories &#40;Bonferroni correction&#41;&#46;</p>"
            ]
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">Plain radiography &#40;Rx&#41; in head trauma caused by falls in infants aged less than 1 year &#40;univariate analysis&#41;&#46;</p>"
        ]
      ]
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        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at4"
            "detalle" => "Table "
            "rol" => "short"
          ]
        ]
        "tabla" => array:3 [
          "leyenda" => "<p id="spar0085" class="elsevierStyleSimplePara elsevierViewall">The table shows the overall <span class="elsevierStyleItalic">p</span>-value&#44; while the text specifies the particular <span class="elsevierStyleItalic">p</span>-value for comparisons of 2 categories that were significant&#46;</p><p id="spar0090" class="elsevierStyleSimplePara elsevierViewall">The category with a significantly greater frequency of CT scan ordering compared to other mechanisms is presented in boldface&#46;</p><p id="spar0095" class="elsevierStyleSimplePara elsevierViewall">PE&#58; physical examination</p>"
          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="left" valign="top" scope="col">Head CT scan&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col">Yes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col">No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col"><span class="elsevierStyleItalic">p</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr><tr title="table-row"><th class="td" title="table-head  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">N</span> &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">N</span> &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry  " colspan="4" align="left" valign="top"><span class="elsevierStyleItalic">Skull lesions in PE</span></td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>None&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">6 &#40;1&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">335 &#40;98&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Haematoma&#47;fracture&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">72 &#40;11&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">562 &#40;88&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#60;0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Other&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">22 &#40;100&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="4" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="4" align="left" valign="top"><span class="elsevierStyleItalic">Fall height</span><a class="elsevierStyleCrossRef" href="#tblfn0015"><span class="elsevierStyleSup">a</span></a></td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>&#60;100<span class="elsevierStyleHsp" style=""></span>cm&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">65 &#40;7&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">861 &#40;92&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#46;037&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>&#62;100<span class="elsevierStyleHsp" style=""></span>cm&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">12 &#40;13&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">80 &#40;87&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="4" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="4" align="left" valign="top"><span class="elsevierStyleItalic">Age</span></td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>&#60;3<span class="elsevierStyleHsp" style=""></span>months&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">19 &#40;20&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">72 &#40;79&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#60;0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>&#62;3<span class="elsevierStyleHsp" style=""></span>months&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">59 &#40;6&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">872 &#40;93&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="4" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="4" align="left" valign="top"><span class="elsevierStyleItalic">Fall mechanism</span><a class="elsevierStyleCrossRef" href="#tblfn0020"><span class="elsevierStyleSup">b</span></a></td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Infant equipment&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">49 &#40;6&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">660 &#40;93&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Furniture&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1 &#40;2&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">46 &#40;97&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleBold">Carer&#39;s arms</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">16 &#40;17&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">74 &#40;82&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Standing height&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1 &#40;1&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">56 &#40;98&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Other&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">11 &#40;9&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">107 &#40;90&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="4" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="4" align="left" valign="top"><span class="elsevierStyleItalic">Witnessing of fall</span></td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Witnessed&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">60 &#40;8&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">635 &#40;91&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#46;079&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Not witnessed&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">18 &#40;5&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">309 &#40;94&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
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            0 => array:3 [
              "identificador" => "tblfn0015"
              "etiqueta" => "a"
              "nota" => "<p class="elsevierStyleNotepara" id="npar0015">Missing data for 4 patients for whom the height of the fall is unknown&#46;</p>"
            ]
            1 => array:3 [
              "identificador" => "tblfn0020"
              "etiqueta" => "b"
              "nota" => "<p class="elsevierStyleNotepara" id="npar0020">An adjustment for multiple comparisons was made for variables with more than 2 categories &#40;Bonferroni correction&#41;&#46;</p>"
            ]
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0080" class="elsevierStyleSimplePara elsevierViewall">Head computed tomography in fall cases in infants aged less than 1 year &#40;univariate analysis&#41;&#46;</p>"
        ]
      ]
      5 => array:8 [
        "identificador" => "tbl0025"
        "etiqueta" => "Table 5"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at5"
            "detalle" => "Table "
            "rol" => "short"
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        ]
        "tabla" => array:1 [
          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Final diagnosis&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">n</span> &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Mild head trauma&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">874 &#40;85&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Skull fracture&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">72 &#40;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Facial trauma&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">61 &#40;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Intracranial haemorrhage&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">16 &#40;1&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Dental trauma&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">15 &#40;1&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Long bone fracture&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">12 &#40;1&#46;1&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Clavicle fracture&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">10 &#40;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Extremity trauma&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">9 &#40;0&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Orbital fracture&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2 &#40;0&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Other&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">11 &#40;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
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        "descripcion" => array:1 [
          "en" => "<p id="spar0100" class="elsevierStyleSimplePara elsevierViewall">Final diagnosis&#46;</p>"
        ]
      ]
      6 => array:8 [
        "identificador" => "tbl0030"
        "etiqueta" => "Table 6"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at6"
            "detalle" => "Table "
            "rol" => "short"
          ]
        ]
        "tabla" => array:1 [
          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">p</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">OR&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">95&#37; CI&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Age less than 3 months&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#60;0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">6&#46;466&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3&#46;524&#8211;11&#46;864&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Height<span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span>50<span class="elsevierStyleHsp" style=""></span>cm&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;016&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&#46;158&nbsp;\t\t\t\t\t\t\n
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