Burkhart Zachary N, Thurber Clinton J, Chuang Alice Z, Kumar Kartik S, Davis Garvin H, Kellaway Judianne
Ruiz Department of Ophthalmology and Visual Science, The University of Texas Medical School at Houston, Houston, Texas; Robert Cizik Eye Clinic, Houston, Texas.
Ruiz Department of Ophthalmology and Visual Science, The University of Texas Medical School at Houston, Houston, Texas.
J AAPOS. 2015 Apr;19(2):119-23. doi: 10.1016/j.jaapos.2014.12.007. Epub 2015 Mar 28.
To determine risk factors associated with retinal hemorrhage (RH) in pediatric abusive head trauma (AHT) suspects.
Records of children aged 0-3 years hospitalized for suspected AHT from January 2007 to November 2011 were retrospectively reviewed in this case-control study. Children were classified into case and control groups based on RH presence. Medical history, presenting symptoms, reasons, and characteristics of injury were recorded. Logistic regression analysis was performed to identify risk factors.
A total of 168 children (104 males) were included. Of these, 103 were classified as cases and 65 as controls. The mean age (with standard deviation) was 9.3 ± 8.3 months (range, 1 day-36 months). Of the 103 cases, 22 (21%) had subretinal hemorrhage, 9 (9%) had retinoschisis, and 1 (1%) had vitreous hemorrhage. Children presenting with lethargy or altered mental status (P < 0.0001), subdural hemorrhage (P < 0.0001), and other radiologic findings (eg, cerebral ischemia, diffuse axonal injury, hydrocephalus, or solid organ injury; P = 0.01546) were likely to have RH. All 23 children with skull or nonskull fracture without intracranial hemorrhage did not have RH (P < 0.0001 both categories).
Retinal hemorrhages were almost never found in the absence of intracranial hemorrhage and not found in the setting of fracture without intracranial hemorrhage.
确定疑似小儿虐待性头部创伤（AHT）患儿视网膜出血（RH）的相关危险因素。
在这项病例对照研究中，对2007年1月至2011年11月因疑似AHT住院的0至3岁儿童的记录进行回顾性分析。根据是否存在RH将儿童分为病例组和对照组。记录病史、症状、受伤原因及损伤特征。进行逻辑回归分析以确定危险因素。
共纳入168名儿童（104名男性）。其中，103名被分类为病例组，65名作为对照组。平均年龄（标准差）为9.3±8.
