de Silva S, Oates R K
Sydney University Department of Paediatrics and Child Health, Children's Hospital, Camperdown, NSW.
Med J Aust. 1993 Mar 1;158(5):300-1.
To review cases of fatal child abuse, looking for any characteristic features of these cases.
A case review of all childhood deaths at The Children's Hospital, Camperdown, between January 1976 and December 1990. Cases with a definite diagnosis of child abuse were extracted. Cases where there was only a suspicion of child abuse as the cause of death were not included.
Seventeen cases of fatal child abuse were reviewed with emphasis on autopsy findings and sociological data.
All children who died were less than three years of age; nine were under one year. Seventy-six per cent died from head injury and 24% from asphyxia or strangulation. In addition to their fatal injuries, 41% had multiple bruises on the trunk and limbs. Thirty-five per cent had evidence of previous physical abuse.
The commonest age for fatal child abuse is the first year of life. When physical abuse occurs in children under three years, and particularly under one year, a thorough assessment, follow-up and institution of appropriate supportive services are essential, as the abuse may be an early warning of a subsequent fatal episode of abuse. The introduction of a process of review of child deaths may increase awareness of and help prevent fatal child abuse.
回顾致命性虐待儿童的案例，寻找这些案例的任何特征。
对1976年1月至1990年12月期间坎珀当儿童医院所有儿童死亡病例进行回顾。提取明确诊断为虐待儿童的病例。不包括仅怀疑虐待儿童为死因的病例。
回顾了17例致命性虐待儿童的病例，重点关注尸检结果和社会学数据。
所有死亡儿童均未满三岁；9例年龄在一岁以下。76%死于头部损伤，24%死于窒息或勒死。除致命伤外，41%的儿童躯干和四肢有多处瘀伤。35%有既往身体虐待的证据。
致命性虐待儿童最常见的年龄是一岁。当三岁以下尤其是一岁以下儿童遭受身体虐待时，进行全面评估、随访并提供适当的支持性服务至关重要，因为这种虐待可能是随后致命性虐待事件的早期预警。引入儿童死亡审查程序可能会提高对致命性虐待儿童的认识并有助于预防此类事件。
