| Autor: |
Jenny, Carole, Hymel, Kent P., Ritzen, Alene, Reinhart, Steven E., Hay, Thomas C., Jenny, C, Hymel, K P, Ritzen, A, Reinert, S E, Hay, T C |
| Předmět: |
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| Zdroj: |
JAMA: Journal of the American Medical Association; 2/17/99, Vol. 281 Issue 7, p621-626, 6p, 5 Charts |
| Abstrakt: |
Context: Abusive head trauma (AHT) is a dangerous form of child abuse that can be difficult to diagnose in young children.Objectives: To determine how frequently AHT was previously missed by physicians in a group of abused children with head injuries and to determine factors associated with the unrecognized diagnosis.Design: Retrospective chart review of cases of head trauma presenting between January 1, 1990, and December 31, 1995.Setting: Academic children's hospital.Patients: One hundred seventy-three children younger than 3 years with head injuries caused by abuse.Main Outcome Measures: Characteristics of head-injured children in whom diagnosis of AHT was unrecognized and the consequences of the missed diagnoses.Results: Fifty-four (31.2%) of 173 abused children with head injuries had been seen by physicians after AHT and the diagnosis was not recognized. The mean time to correct diagnosis among these children was 7 days (range, 0-189 days). Abusive head trauma was more likely to be unrecognized in very young white children from intact families and in children without respiratory compromise or seizures. In 7 of the children with unrecognized AHT, misinterpretation of radiological studies contributed to the delay in diagnosis. Fifteen children (27.8%) were reinjured after the missed diagnosis. Twenty-two (40.7%) experienced medical complications related to the missed diagnosis. Four of 5 deaths in the group with unrecognized AHT might have been prevented by earlier recognition of abuse.Conclusion: Although diagnosing head trauma can be difficult in the absence of a history, it is important to consider inflicted head trauma in infants and young children presenting with nonspecific clinical signs. [ABSTRACT FROM AUTHOR] |
| Databáze: |
Complementary Index |
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