Risk factors associated with retinal hemorrhage in suspected abusive head trauma
| Autor: | Judianne Kellaway, Alice Z. Chuang, Garvin H. Davis, Zachary N. Burkhart, Clinton J. Thurber, Kartik S. Kumar |
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| Rok vydání: | 2015 |
| Předmět: |
Male
Child abuse Pediatrics medicine.medical_specialty Retinoschisis Article Head trauma Diagnosis Differential Lethargy Hematoma Risk Factors medicine Craniocerebral Trauma Humans Medical history Child Abuse Retrospective Studies Skull Fractures business.industry Incidence (epidemiology) Infant Newborn Infant Retinal Hemorrhage Retrospective cohort study medicine.disease Texas Vitreous Hemorrhage 3. Good health Surgery Hospitalization Ophthalmology Hematoma Subdural Case-Control Studies Child Preschool Pediatrics Perinatology and Child Health Vitreous hemorrhage Female Tomography X-Ray Computed business |
| Zdroj: | Journal of AAPOS : the official publication of the American Association for Pediatric Ophthalmology and Strabismus / American Association for Pediatric Ophthalmology and Strabismus |
| ISSN: | 1091-8531 |
| Popis: | Purpose To determine risk factors associated with retinal hemorrhage (RH) in pediatric abusive head trauma (AHT) suspects. Methods Records of children aged 0–3 years hospitalized for suspected AHT from January 2007 to November 2011 were retrospectively reviewed in this case–control study. Children were classified into case and control groups based on RH presence. Medical history, presenting symptoms, reasons, and characteristics of injury were recorded. Logistic regression analysis was performed to identify risk factors. Results A total of 168 children (104 males) were included. Of these, 103 were classified as cases and 65 as controls. The mean age (with standard deviation) was 9.3 ± 8.3 months (range, 1 day-36 months). Of the 103 cases, 22 (21%) had subretinal hemorrhage, 9 (9%) had retinoschisis, and 1 (1%) had vitreous hemorrhage. Children presenting with lethargy or altered mental status (P < 0.0001), subdural hemorrhage (P < 0.0001), and other radiologic findings (eg, cerebral ischemia, diffuse axonal injury, hydrocephalus, or solid organ injury; P = 0.01546) were likely to have RH. All 23 children with skull or nonskull fracture without intracranial hemorrhage did not have RH (P < 0.0001 both categories). Conclusions Retinal hemorrhages were almost never found in the absence of intracranial hemorrhage and not found in the setting of fracture without intracranial hemorrhage. |
| Databáze: | OpenAIRE |
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