Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore.
Ann Acad Med Singap. 2018 Oct;47(10):413-419.
There is an increasing trend of physical child abuse cases reported in Singapore. Children presenting to the Emergency Department with injuries require a high index of suspicion for clinicians to distinguish those that are abusive in nature.
A retrospective study of children with diagnosis of NAI presenting to KK Women's and Children's Hospital (KKH) from June 2011 to May 2016 was conducted.
There were 1917 cases reported from 1730 subjects, of which: 8.8% of subjects had repeat visits; 55.2% of cases were male; and mean age was 7.69 years. Racial demographics were: Chinese 45.5%, Malay 33.4%, Indian 15.4% and Others 5.9%. The most frequent injuries sustained were head and neck (50.8%), limbs (32.2%), and chest (5.7%). Of the type of injuries, 55% had contusions, 21% had cane marks, 16% had lacerations, 4.4% had burn marks and 1% sustained fractures. Males were more likely to be caned ( <0.001); 54.9% of cases were admitted and 38.9% were discharged. Cases that presented without a parent ( <0.001), were known to Child Protective Service ( <0.001), or had a history of parental substance abuse ( = 0.038), mental illness in caregiver ( = 0.021), or domestic violence ( <0.001) were more likely to require admission.
Analysing these factors provide a better understanding of the presentation of NAI cases, including 'red flags' and vulnerable groups who should have better protection.
新加坡报告的儿童躯体虐待案件呈上升趋势。对于临床医生来说，儿童因受伤就诊时需要高度怀疑这些伤害是否具有虐待性质。
对 2011 年 6 月至 2016 年 5 月期间在 KK 妇女儿童医院（KKH）就诊的诊断为非故意性身体虐待（NAI）的儿童进行回顾性研究。
从 1730 名患儿中报告了 1917 例病例，其中：8.8%的患儿有复诊；55.2%的患儿为男性；平均年龄为 7.69 岁。种族分布为：华人 45.5%，马来人 33.4%，印度人 15.4%，其他种族 5.9%。最常见的受伤部位为头颈部（50.8%）、四肢（32.2%）和胸部（5.7%）。受伤类型中，挫伤占 55%，棍棒伤占 21%，撕裂伤占 16%，烧伤占 4.4%，骨折占 1%。男性更有可能被棍棒殴打（<0.001）；54.9%的患儿入院，38.9%的患儿出院。未随父母就诊（<0.001）、已知有儿童保护服务机构介入（<0.001）、或有父母药物滥用史（=0.038）、照顾者有精神病史（=0.021）或家庭暴力史（<0.001）的患儿更有可能需要入院治疗。
分析这些因素有助于更好地了解 NAI 病例的表现，包括“危险信号”和易受伤害的群体，以便为他们提供更好的保护。
