Testing for Abuse in Children With Sentinel Injuries
Testing for Abuse in Children With Sentinel Injuries
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DOI：
10.1542/peds.2015-1487
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发表时间：
2015-11-01
期刊：
影响因子：
8
通讯作者：
Runyan, Desmond K.
中科院分区：
文献类型：
--
作者：
Lindberg, Daniel M.;Beaty, Brenda;Runyan, Desmond K.
目的：儿童身体虐待通常被忽视，使受虐待的儿童处于重复伤害和死亡的风险之中。一些所谓的“前哨”损伤被认为与高滥用率有关，并意味着需要对其他隐性创伤进行常规检测。我们的目的是确定率的滥用评估和诊断儿童评估在领先的儿童医院与这些假定的哨兵injuries.METHODS：这是一个回顾性的二次分析的儿科健康信息系统数据库。我们确定了30355名儿童与假定的前哨损伤。我们测量的滥用诊断率和测试率通常用于识别隐匿性injuries.RESULTS：在所有访问的儿童，24个月大的儿科健康信息系统医院，滥用诊断率为0.17%。至少有一个假定的前哨损伤的儿童的滥用诊断率范围从3.5%的儿童，12个月大的烧伤到56.1%的儿童，24个月大的肋骨骨折。骨骼调查和其他测试，可以确定隐匿性创伤injuries.CONCLUSIONS：几个假定的哨兵损伤与身体虐待的高发病率之间的中心和不同injuries.CONCLUSIONS：高度可变的率。在符合条件的肋骨骨折、腹部创伤或颅内出血儿童中，滥用率超过20%。未来的工作是必要的，以测试是否在这些儿童的虐待常规测试可以提高早期识别的虐待。
OBJECTIVE: Child physical abuse is commonly missed, putting abused children at risk for repeated injury and death. Several so-called sentinel injuries have been suggested to be associated with high rates of abuse, and to imply the need for routine testing for other, occult traumatic injuries. Our objective was to determine rates of abuse evaluation and diagnosis among children evaluated at leading children's hospitals with these putative sentinel injuries.METHODS: This is a retrospective secondary analysis of the Pediatric Health Information System database. We identified 30 355 children with putative sentinel injuries. We measured rates of abuse diagnosis and rates of testing commonly used to identify occult injuries.RESULTS: Among all visits for children,24 months old to Pediatric Health Information System hospitals, the rate of abuse diagnosis was 0.17%. Rates of abuse diagnosis for children with at least 1 putative sentinel injury ranged from 3.5% for children,12 months old with burns to 56.1% for children,24 months with rib fractures. Rates of skeletal survey and other testing that can identify occult traumatic injury were highly variable between centers and for different injuries.CONCLUSIONS: Several putative sentinel injuries are associated with high rates of physical abuse. Among eligible children with rib fracture(s), abdominal trauma, or intracranial hemorrhage, rates of abuse were more than 20%. Future work is warranted to test whether routine testing for abuse in these children can improve early recognition of abuse.