Lavin Lindsay R, Penrod Cody H, Estrada Cristina M, Arnold Donald H, Saville Benjamin R, Xu Meng, Lowen Deborah E
1 Vanderbilt University, Nashville, TN, USA.
2 Wake Emergency Physicians, PA, Cary, NC, USA.
Clin Pediatr (Phila). 2018 Sep;57(10):1161-1167. doi: 10.1177/0009922818759319. Epub 2018 Feb 16.
Approximately one fourths of infant fractures are due to abuse. Recognition of abuse is important to avoid further morbidity/mortality. There is limited knowledge regarding how frequently pediatric emergency department clinicians consider abuse in infants with fractures. Our primary objective was to estimate the percentage of infants with fractures for whom abuse was considered, and to examine characteristics associated with abuse consideration. We performed a retrospective review of infants <1 year of age presenting to a pediatric emergency department. Our primary outcome variable was consideration of abuse. Our secondary outcome measures were identification of predictor variables associated with consideration of abuse. We identified 509 infants meeting study criteria. Pediatric emergency physicians considered abuse in approximately two thirds of infants with fractures. Consideration was more likely to occur in younger infants, in the presence of no history or unwitnessed injury mechanism, when evaluated by male physicians, and emergency department encounters from 12 am to 6 am.
大约四分之一的婴儿骨折是由虐待所致。识别虐待情况对于避免进一步的发病/死亡至关重要。关于儿科急诊科临床医生在处理骨折婴儿时考虑虐待情况的频率，目前了解有限。我们的主要目标是估计被考虑存在虐待情况的骨折婴儿的百分比，并检查与考虑虐待相关的特征。我们对到儿科急诊科就诊的1岁以下婴儿进行了回顾性研究。我们的主要结局变量是对虐待情况的考虑。次要结局指标是识别与考虑虐待相关的预测变量。我们确定了509名符合研究标准的婴儿。儿科急诊科医生在大约三分之二的骨折婴儿中考虑了虐待情况。在年龄较小的婴儿中、无受伤史或受伤机制无目击证人时、由男医生进行评估时以及在凌晨12点至早上6点期间的急诊科就诊中，更有可能考虑虐待情况。
