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Graefe's Archive for Clinical and Experimental Ophthalmology 2018-May

Pediatric abusive head trauma in Taiwan: clinical characteristics and risk factors associated with mortality.

يمكن للمستخدمين المسجلين فقط ترجمة المقالات
الدخول التسجيل فى الموقع
يتم حفظ الارتباط في الحافظة
An-Lun Wu
Lai-Chu See
Shao-Hsuan Hsia
Hui-Tzu Tu
Nan-Kai Wang
Jing-Long Huang
Yih-Shiou Hwang
Chi-Chun Lai
Wei-Chi Wu

الكلمات الدالة

نبذة مختصرة

OBJECTIVE

To report the clinical characteristics of abusive head trauma (AHT) in Taiwan and identify the risk factors associated with mortality of these patients.

METHODS

Children with clinically diagnosed AHT from January 1, 2000, to October 31, 2015 were reviewed. The demographic data, clinical features, and associated retinal and radiologic findings were analyzed. The multivariable logistic regression model analysis was performed to identify the risk factors associated with in-hospital mortality.

RESULTS

A total of 75 children were included. The mean age was 7.31 ± 6.57 months (range, 1-36 months). Retinal hemorrhages were detected in 69 children with AHT (92%). The majority of retinal hemorrhages were characterized by hemorrhagic numbers higher than ten (74.7%), multi-layered (54.7%), and extension beyond the posterior pole to the peripheral retina (73.3%). Twenty children (26.7%) had macular retinoschisis. As a direct result of AHT, ten children died in the hospital (13.3%). Logistic regression showed that respiratory distress or apnea (adjusted odds ratio [OR] = 22.46; 95% confidence interval [CI], 2.24-225.33; P = .0082), vomiting (adjusted OR = 11.94; 95% CI, 1.31-108.403; P = .0276), retinal finding of macular retinoschisis (adjusted OR = 8.9; 95% CI, 1.01-78.65; P = .0493), and the presence of subarachnoid hemorrhage (SAH) (adjusted OR = 15.17; 95% CI, 1.40-64.84; P = .0255) were independently associated with mortality.

CONCLUSIONS

Respiratory distress or apnea, vomiting, SAH, and macular retinoschisis are independently associated with mortality in abusive head trauma. A complete ophthalmologic examination with the immediate visualization of intraocular injury should be performed to clarify the likelihood of child abuse and predict a potential poor neurologic outcome.

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قاعدة بيانات الأعشاب الطبية الأكثر اكتمالا التي يدعمها العلم

  • يعمل في 55 لغة
  • العلاجات العشبية مدعومة بالعلم
  • التعرف على الأعشاب بالصورة
  • خريطة GPS تفاعلية - ضع علامة على الأعشاب في الموقع (قريبًا)
  • اقرأ المنشورات العلمية المتعلقة ببحثك
  • البحث عن الأعشاب الطبية من آثارها
  • نظّم اهتماماتك وابقَ على اطلاع دائم بأبحاث الأخبار والتجارب السريرية وبراءات الاختراع

اكتب أحد الأعراض أو المرض واقرأ عن الأعشاب التي قد تساعد ، واكتب عشبًا واطلع على الأمراض والأعراض التي تستخدم ضدها.
* تستند جميع المعلومات إلى البحوث العلمية المنشورة

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