Hicks Ralph A, Laskey Antoinette L, Harris Tara L, Hibbard Roberta A
Indiana University, Indianapolis, IN, USA.
Riley Hospital for Children, Indianapolis, IN, USA.
Clin Pediatr (Phila). 2020 Jul;59(8):809-815. doi: 10.1177/0009922820920019. Epub 2020 May 18.
This study describes a hospital-based child abuse pediatrics consultation service. Medical records for all child abuse pediatrics consultations during 2006 to 2009 were reviewed. Descriptive statistics were used for data analysis. Of 2495 consultations, 13 were excluded due to insufficient information, 1682 were examinations for suspected sexual abuse, and 800 were examinations for nonsexual abuse concerns. Among the latter group of 800 patients, the most common reasons for consultation were fracture (33.5%), nonburn skin injury (16.8%), burn (15.4%), and intracranial injury (13.2%). Median patient age was 11 months (range = 3 days to 16 years). Case fatality rate was 3.9%. Final diagnosis was classified as definite/likely abuse in 40.0%, questionable/unknown in 24.5%, definite/likely accident in 23.6%, no injury in 4.6%, neglect in 4.0%, and a medical condition in 3.2%. Therefore, among consultations requested for suspected child maltreatment, a child abuse pediatrician concluded that abuse was definite or likely in less than half of patients.
本研究描述了一项基于医院的儿童虐待儿科咨询服务。回顾了2006年至2009年期间所有儿童虐待儿科咨询的病历。采用描述性统计进行数据分析。在2495次咨询中,13次因信息不足被排除,1682次是对疑似性虐待的检查,800次是对非性虐待相关问题的检查。在这800名患者中,最常见的咨询原因是骨折(33.5%)、非烧伤性皮肤损伤(16.8%)、烧伤(15.4%)和颅内损伤(13.2%)。患者年龄中位数为11个月(范围为3天至16岁)。病死率为3.9%。最终诊断分类为确定/可能为虐待的占40.0%,可疑/不明的占24.5%,确定/可能为意外的占23.6%,无损伤的占4.6%,忽视的占4.0%,以及疾病的占3.2%。因此,在因疑似儿童虐待而进行的咨询中,儿童虐待儿科医生得出结论,不到一半的患者存在确定或可能的虐待情况。