Pawlik Marie-Christin, Kemp Alison, Maguire Sabine, Nuttall Diane, Feldman Kenneth W, Lindberg Daniel M
Institute of Primary Care & Public Health, Cardiff University School of Medicine, Neuadd Meirionnydd, Heath Park, Cardiff, UK.
Institute of Primary Care & Public Health, Cardiff University School of Medicine, Neuadd Meirionnydd, Heath Park, Cardiff, UK.
Child Abuse Negl. 2016 May;55:52-61. doi: 10.1016/j.chiabu.2016.03.006. Epub 2016 Apr 16.
Intentional burns represent a serious form of physical abuse that must be identified to protect children from further harm. This study is a retrospectively planned secondary analysis of the Examining Siblings To Recognize Abuse (ExSTRA) network data. Our objective was to describe the characteristics of burns injuries in children referred to Child Abuse Pediatricians (CAPs) in relation to the perceived likelihood of abuse. We furthermore compare the extent of diagnostic investigations undertaken in children referred to CAPs for burn injuries with those referred for other reasons. Within this dataset, 7% (215/2890) of children had burns. Children with burns were older than children with other injuries (median age 20 months vs. 10 months). Physical abuse was perceived as likely in 40.9% (88) and unlikely in 59.1% (127). Scalds accounted for 52.6% (113) and contact burns for 27.6% (60). Several characteristics of the history and burn injury were associated with a significantly higher perceived likelihood of abuse, including children with reported inflicted injury, absent or inadequate explanation, hot water as agent, immersion scald, a bilateral/symmetric burn pattern, total body surface area ≥10%, full thickness burns, and co-existent injuries. The rates of diagnostic testing were significantly lower in children with burns than other injuries, yet the yield of skeletal survey and hepatic transaminases testing were comparable between the two groups. This would imply that children referred to CAPs for burns warrant the same level of comprehensive investigations as those referred for other reasons.
故意烧伤是一种严重的身体虐待形式，必须予以识别，以保护儿童免受进一步伤害。本研究是对“检查兄弟姐妹以识别虐待行为”（ExSTRA）网络数据进行的回顾性计划二次分析。我们的目的是描述转介给儿童虐待儿科医生（CAPs）的儿童烧伤损伤的特征，以及与感知到的虐待可能性的关系。此外，我们还比较了因烧伤转介给CAPs的儿童与因其他原因转介的儿童所进行的诊断性检查的程度。在该数据集中，7%（215/2890）的儿童有烧伤。烧伤儿童比其他受伤儿童年龄大（中位年龄20个月对10个月）。40.9%（88例）的儿童被认为可能遭受身体虐待，59.1%（127例）被认为不太可能。烫伤占52.6%（113例），接触性烧伤占27.6%（60例）。病史和烧伤损伤的几个特征与明显更高的感知虐待可能性相关，包括报告有受伤情况、缺乏或解释不充分、烫伤源为热水、浸泡烫伤、双侧/对称烧伤模式、全身表面积≥10%、全层烧伤以及并存损伤。烧伤儿童的诊断性检查率明显低于其他受伤儿童，但两组之间骨骼检查和肝转氨酶检测的阳性率相当。这意味着因烧伤转介给CAPs的儿童应接受与因其他原因转介的儿童相同水平的全面检查。
