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Characteristics of children with vomiting after minor head trauma: a case-control study
Liviana Da Dalt1, Barbara Andreola, Paola Facchin
1Pediatric Emergency Department, University of Padova, Padova, Italy. dadalt@pediatria.unipd.it
Insights
Vomiting after minor head injuries in children is linked to a history of motion sickness, recurrent vomiting, or headaches. Family history of these conditions also increases risk, not intracranial lesions.
Area of Science:
- Pediatric Emergency Medicine
- Neurotrauma
- Clinical Pediatrics
Background:
- Vomiting is a common symptom following minor head trauma in children.
- Identifying predictors of post-traumatic vomiting is crucial for accurate diagnosis and management.
- Distinguishing between benign and serious causes of vomiting is essential in pediatric head injury cases.
Purpose of the Study:
- To investigate factors associated with vomiting in children after minor head trauma.
- To determine if personal or familial history influences the occurrence of post-traumatic vomiting.
- To differentiate predictors of vomiting unrelated to intracranial pathology.
Main Methods:
- A case-control study involving 1097 children with minor head injuries.
- 162 children with vomiting (cases) were matched with 296 children without vomiting (controls) by age.
- Analysis focused on personal history (headaches, motion sickness, recurrent vomiting) and family history.
Main Results:
- Personal history of recurrent vomiting (OR 5.90) and motion sickness (OR 2.34) were significant predictors.
- Headache at the time of injury (OR 4.37) and family history of similar issues (OR 1.66) were also strong indicators.
- Personal and family predispositions were more common in children who vomited.
Conclusions:
- Post-traumatic vomiting in children is significantly associated with personal and familial predispositions.
- These factors are more indicative of vomiting than the presence of intracranial lesions.
- History of recurrent vomiting, motion sickness, and headaches are key indicators.
Objective:
To study selected factors associated with vomiting after minor head trauma in children.
Study Design:
During a 1-year study, 1097 children with a minor head injury were consecutively discharged from the pediatric emergency department; 162 had associated vomiting. A case-control study was conducted, with each subject matched with 2 children of the same age group with a minor head injury who did not have associated vomiting. Final analysis was conducted in 148 case subjects and 296 matched control subjects.
Results:
With univariate analysis, a personal history of recurrent headache (6.1% versus 2.4%), motion sickness (27% versus 11.8%), and recurrent vomiting (6.1% versus 0.7%) were significantly more common in the vomiting group, as was a family history of recurrent headache in parents (45.9% versus 27%) or motion sickness in parents (26.4% versus 15.2%) or siblings (14.2% versus 3.7%). The strongest predictors of vomiting were a personal history of recurrent vomiting (odds ratio, 5.90; 95% CI, 1.18-29.47), motion sickness (odds ratio, 2.34; 95% CI, 1.32-4.10), headache at the time of the injury (odds ratio, 4.37; 95% CI, 2.23-8.57), and a strong family history of the same recurrent problems (odds ratio, 1.66; 95% CI, 1.29-2.13).
Conclusions:
Post-traumatic vomiting is significantly related to personal or familial predisposition to vomit rather than to the presence of intracranial lesions.
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