Consistent screening of admitted infants with head injuries reveals high rate of nonaccidental trauma
Topic overview
Retrospective study of 563 infants screened for nonaccidental trauma (NAT) after unwitnessed head injuries found 25.6% were abuse victims. Skeletal survey showed 94% positive predictive value, and injury severity score, abnormal skeletal survey, and insurance status (not race) significantly predicted NAT, supporting routine screening protocols.
Key takeaways
- 25.6% of infants admitted with unwitnessed head injuries were confirmed victims of nonaccidental trauma through systematic screening.
- Skeletal survey demonstrated 94% positive predictive value for identifying nonaccidental trauma in screened infants.
- Insurance status (public/none) correlated with NAT risk, but race did not predict abuse when controlling for other factors.
- Consistent screening protocol eliminated racial disparities in NAT evaluation and prevented missed cases of intentional injury.
- Higher injury severity scores were significantly associated with confirmed nonaccidental trauma cases.
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