Department of Pediatrics, Section of Emergency Medicine, Yale University School of Medicine, 100 York Street, Suite 1F, New Haven, Connecticut, 06511, USA.
Department of Pediatrics, Section of General Pediatrics, Yale University School of Medicine, Dana Clinic Building Basement, 789 Howard Avenue, New Haven, Connecticut, 06519, USA.
Child Abuse Negl. 2019 Mar;89:70-77. doi: 10.1016/j.chiabu.2019.01.006.
Oral injuries in young children may indicate physical abuse. The prevalence of oral injuries in young children presenting to the emergency department is unknown. These data would assist providers in making decisions about the need for further abuse evaluation.
To determine the prevalence of oral injuries, associated chief complaints and characteristics, and frequency of abuse evaluations in children younger than 24 months presenting to a pediatric emergency department (PED).
Twelve pediatric emergency medicine physicians consecutively enrolled children younger than 24 months in a tertiary care PED.
We performed a prospective observational study. Enrolled patients underwent a complete oral examination. Providers recorded patient demographics, type of chief complaint, oral injury details, developmental ability, and the presence of an abuse evaluation.
Oral injuries occurred in 36/1303 (2.8%, 95% CI 1.9-3.8%) and were more common in patients with traumatic (26/200, 13%) versus medical chief complaints (10/1,103, 0.9%) (p < .001). Of patients with oral injuries (36), 78% were mobile and 72% had traumatic chief complaints. Nine (25%) children with oral injuries were evaluated for abuse. Oral injuries in children 0-11 months old were more likely to be evaluated for abuse than children 12-24 months old (70.0% vs. 7.7%, p < .001).
The prevalence of oral injuries in children <24 months old presenting to a PED was low. Most occurred in mobile children and in children with traumatic chief complaints. Younger, non-mobile children with oral injuries had a higher likelihood of having an abuse evaluation.
幼儿口腔损伤可能表明存在身体虐待。目前尚不清楚到急诊就诊的幼儿口腔损伤的患病率。这些数据将有助于医生决定是否需要进一步进行虐待评估。
确定在儿科急诊就诊的 24 个月以下儿童口腔损伤的患病率、相关主要症状和特征以及虐待评估的频率。
12 名儿科急诊医生连续纳入了一家三级保健儿科急诊的 24 个月以下儿童。
我们进行了一项前瞻性观察性研究。入组患者接受了全面的口腔检查。医生记录了患者的人口统计学数据、主要症状类型、口腔损伤详细信息、发育能力以及虐待评估的情况。
在 1303 名儿童中，有 36 名（2.8%，95%CI 1.9-3.8%）发生了口腔损伤，且创伤性（26/200，13%）主诉患者的口腔损伤发生率高于非创伤性（10/1，1103，0.9%）（p < .001）。在有口腔损伤的 36 名儿童中，78%的儿童可以活动，72%的儿童有创伤性主诉。9 名（25%）有口腔损伤的儿童接受了虐待评估。0-11 个月大的有口腔损伤的儿童比 12-24 个月大的儿童更有可能接受虐待评估（70.0% vs. 7.7%，p < .001）。
儿科急诊就诊的 24 个月以下儿童口腔损伤的患病率较低。大多数发生在可活动的儿童和有创伤性主要症状的儿童中。有口腔损伤且年龄较小、不能活动的儿童更有可能接受虐待评估。
