Occult abusive injuries in children brought for care after intimate partner violence: An exploratory study.
Occult abusive injuries in children brought for care after intimate partner violence: An exploratory study.
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亲密伴侣暴力后送医儿童的隐性虐待伤害：一项探索性研究。
DOI：
10.1016/j.chiabu.2018.02.003
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发表时间：
2018
影响因子：
4.8
通讯作者：
ExSTRAInvestigators
中科院分区：
文献类型：
--
作者：
Tiyyagura,Gunjan;Christian,Cindy;Berger,Rachel;Lindberg,Daniel;ExSTRAInvestigators
家庭中存在亲密伴侣暴力的儿童遭受身体虐待的风险增加。我们通过回顾性分析“兄弟姐妹检查以识别虐待”的身体虐待儿童队列，确定了暴露于IPV后接受虐待儿童咨询的频率和伤害模式。选择暴露于IPV后出现的儿童。在儿童虐待儿科医生评估的2890名儿童中，61名（2.1%）患者在暴露于IPV后出现。在61例患者中，11例（18.0%）暴露于IPV，但没有直接参与IPV事件，36例（59.0%）在IPV期间遭受了无意的创伤，14例（23.0%）在IPV期间被直接侵犯。36例（59.0%）有损伤，其中31例（51.0%）有皮肤损伤，15例（24.6%）有内伤，包括骨折、颅内或腹腔损伤。15例内伤患者中，14例（93.3%）年龄小于12个月。在36例损伤患者中，16例（44.4%）无直接损伤报告，1例报告的损伤机制不能解释所识别的损伤，或1例报告的创伤无特定机制。5名（13.9%）没有体检结果显示其内伤程度。暴露于IPV后到急诊科就诊的儿童中有很大一部分受伤。仅凭病史和体格检查不足以发现内伤，尤其是婴儿。这些初步结果支持了对暴露于IPV的儿童隐匿性损伤进行未来前瞻性研究的必要性。
Children in homes with intimate partner violence (IPV) are at increased risk for physical abuse. We determined the frequency and injury patterns in children who underwent child abuse consultation after IPV exposure by retrospectively analyzing the "Examination of Siblings To Recognize Abuse" cohort of children referred for physical abuse. Children were selected who presented after IPV exposure. Among 2890 children evaluated by child abuse pediatricians, 61 (2.1%) patients presented after IPV exposure. Of the 61, 11 (18.0%) were exposed to IPV, but had no direct involvement in the IPV event, 36 (59.0%) sustained inadvertent trauma during IPV, and 14 (23.0%) were directly assaulted during IPV. Thirty-six patients (59.0%) had an injury: 31 (51.0%) had cutaneous injuries and 15 (24.6%) had internal injuries including fracture(s), intracranial or intra-abdominal injury. Of the 15 patients with internal injuries, 14 (93.3%) were less than 12 months old. Among the 36 patients with injuries, 16 (44.4%) had no report of direct injury, a report of a mechanism that did not explain the identified injuries, or a report of trauma without a specific mechanism. Five (13.9%) did not have physical examination findings to suggest the extent of their internal injuries. Injuries are present in a significant proportion of children presenting to Emergency Departments after IPV exposure. History and physical examination alone are insufficient to detect internal injuries especially in infants. These preliminary results support the need for future, prospective studies of occult injury in children exposed to IPV.
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