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Validation of the Pittsburgh Infant Brain Injury Score for Abusive Head Trauma

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dc.contributor.author Berger, Rachel Pardes ; Fromkin, Janet ; Herman, Bruce ; Pierce, Mary Clyde : Saladino, Richard A. ;Flom, Lynda ; Tyler-Kabara, Elizabeth C. ; McGinn, Tom ; Richichi, Rudolph ; Kochanek, Patrick M.
dc.date.accessioned 2021-04-20T17:38:49Z
dc.date.available 2021-04-20T17:38:49Z
dc.date.issued 2016
dc.identifier.citation Berger, Rachel Pardes ; Fromkin, Janet ; Herman, Bruce ; Pierce, Mary Clyde : Saladino, Richard A. ;Flom, Lynda ; Tyler-Kabara, Elizabeth C. ; McGinn, Tom ; Richichi, Rudolph ; Kochanek, Patrick M. (2016). Validation of the Pittsburgh Infant Brain Injury Score for Abusive Head Trauma. Pediatrics, 138(1), e2 0153756. en_US
dc.identifier.uri https://pediatrics.aappublications.org/content/pediatrics/138/1/e20153756.full-text.pdf  
dc.identifier.uri http://hdl.handle.net/11212/5052
dc.description.abstract Background: Abusive head trauma is the leading cause of death from physical abuse. Misdiagnosis of abusive head trauma as well as other types of brain abnormalities in infants is common and contributes to increased morbidity and mortality. We previously derived the Pittsburgh Infant Brain Injury Score (PIBIS), a clinical prediction rule to assist physicians deciding which high-risk infants should undergo computed tomography of the head. Methods: Well-appearing infants 30 to 364 days of age with temperature <38.3°C, no history of trauma, and a symptom associated with an increased risk of having a brain abnormality were eligible for enrollment in this prospective, multicenter clinical prediction rule validation. By using a predefined neuroimaging paradigm, subjects were classified as cases or controls. The sensitivity, specificity, and negative and positive predictive values of the rule for prediction of brain injury were calculated. Results: A total of 1040 infants were enrolled: 214 cases and 826 controls. The 5-point PIBIS included abnormality on dermatologic examination (2 points), age ≥3.0 months (1 point), head circumference >85th percentile (1 point), and serum hemoglobin <11.2g/dL (1 point). At a score of 2, the sensitivity and specificity for abnormal neuroimaging was 93.3% (95% confidence interval 89.0%–96.3%) and 53% (95% confidence interval 49.3%–57.1%), respectively. Conclusions: Our data suggest that the PIBIS accurately identifies infants who would benefit from neuroimaging to evaluate for brain injury. An implementation analysis is needed before the PIBIS can be integrated into clinical practice. (Author Abstract) en_US
dc.language.iso en en_US
dc.publisher Pediatrics en_US
dc.subject child abuse en_US
dc.subject physical abuse en_US
dc.subject research en_US
dc.subject diagnosis en_US
dc.subject head trauma en_US
dc.subject signs and symptoms en_US
dc.title Validation of the Pittsburgh Infant Brain Injury Score for Abusive Head Trauma en_US
dc.type Article en_US


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