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Abusive head trauma and accidental head injury: a 20-year comparative study of referrals to a hospital child protection team

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dc.contributor.author Kelly, P., John, S., Vincent, A. L., & Reed, P.
dc.date.accessioned 2016-08-19T18:11:10Z
dc.date.available 2016-08-19T18:11:10Z
dc.date.issued 2015
dc.identifier.citation Kelly, P., John, S., Vincent, A. L., & Reed, P. (2015). Abusive head trauma and accidental head injury: a 20-year comparative study of referrals to a hospital child protection team. Archives of disease in childhood, 100(12), 1123-1300. en_US
dc.identifier.uri http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4680201/pdf/archdischild-2014-306960.pdf  
dc.identifier.uri http://hdl.handle.net/11212/2907
dc.description.abstract Aim: To describe children referred for suspected abusive head trauma (AHT) to a hospital child protection team in Auckland, New Zealand. Methods: Comparative review of demographics, histories, injuries, investigations and diagnostic outcomes for referrals under 15 years old from 1991 to 2010. Results: Records were available for 345 children. Referrals increased markedly (88 in the first decade, 257 in the second), but the diagnostic ratio was stable: AHT 60%, accidental or natural 29% and uncertain cause 11%. The probability of AHT was similar regardless of socio-economic status or ethnicity. In children under 2 years old with accidental head injuries (75/255, 29%) or AHT (180/255, 71%), characteristics of particular interest for AHT included no history of trauma (88/98, 90%), no evidence of impact to the head (84/93, 90%), complex skull fractures with intracranial injury (22/28, 79%), subdural haemorrhage (160/179, 89%) and hypoxic ischaemic injury (38/39, 97%). In children over 2 years old, these characteristics did not differ significantly between children with accidental head injuries (21/47, 45%) and AHT (26/47, 55%). The mortality of AHT was higher in children over 2 years old (10/26, 38%) than under 2 years (19/180, 11%). Conclusions: The striking increase in referrals for AHT probably represents increasing incidence. The decision to refer a hospitalised child with a head injury for assessment for possible AHT should not be influenced by socio-economic status or ethnicity. Children over 2 years old hospitalised for AHT are usually injured by mechanisms involving impact and should be considered at high risk of death. (Author Abstract) en_US
dc.language.iso en en_US
dc.publisher Archives of disease in childhood en_US
dc.subject child abuse en_US
dc.subject abusive head trauma en_US
dc.subject research en_US
dc.subject prevalence en_US
dc.subject International Resources en_US
dc.subject New Zealand en_US
dc.title Abusive head trauma and accidental head injury: a 20-year comparative study of referrals to a hospital child protection team en_US
dc.type Article en_US


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