A Study of Skeletal Survey Disparity in Pediatric Head Injury in the Emergency Department

被引：2

作者：

Crumm, Caitlin E. ^{[1
,2
]}

Brown, Emily C. B. ^{[2
]}

Uspal, Neil G. ^{[1
]}

Caglar, Derya ^{[1
]}

von Arnim, Amelie von Saint Andre ^{[3
]}

Barry, Dwight ^{[4
]}

Hartford, Emily A. ^{[1
]}

机构：

[1] Seattle Childrens, Dept Emergency Med, Seattle, WA USA

[2] Seattle Childrens, Dept Pediat, Seattle, WA USA

[3] Univ Washington, Dept Crit Care Med, Seattle, WA USA

[4] Seattle Childrens Res Inst, Seattle Childrens, Seattle, WA USA

来源：

CHILD MALTREATMENT | 2024年

关键词：

abusive head trauma; systemic racism; evidence-based practice; INFANTS; CHILDREN; ABUSE; YOUNG; BIAS;

D O I：

10.1177/10775595241282321

中图分类号：

D669 [社会生活与社会问题]; C913 [社会生活与社会问题];

学科分类号：

1204 ;

摘要：

The objective of this study was to evaluate disparities in skeletal survey (SS) use for pediatric. head injury patients in the emergency department (ED). This was a multi-site retrospective. cohort study of children <24 months with concern for head injury and injury on head CT from. 7/1/12 - 1/1/22. We determined adjusted associations between SS completion and race, ethnicity, language for care, insurance type, and income, with sub-analysis of children <6 months and with complex injury. We evaluated occult fracture prevalence. Two-hundred seventy children met criteria and 88 had SS. No statistical association was found between skeletal survey completion and race or ethnicity, language for care, private insurance, median census tract income, or in sub-analyses. Two of 88 (2.3%) patients had occult fracture; both had risk factors for NAT. In conclusion, no statistical association was found between SS completion and demographics. Occult fracture was uncommon. SS use can likely be decreased in lower risk patients.

引用

页数：10

共 33 条

[1] Assessment of factors resulting in abuse evaluations in young children with minor head trauma [J].

Anderst, James D. .

CHILD ABUSE & NEGLECT, 2008, 32 (03) :405-413

[2] Validation of the Pittsburgh Infant Brain Injury Score for Abusive Head Trauma [J].

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. .

PEDIATRICS, 2016, 138 (01)

[3] Risk factors associated with retinal hemorrhage in suspected abusive head trauma [J].

Burkhart, Zachary N. ;

Thurber, Clinton J. ;

Chuang, Alice Z. ;

Kumar, Kartik S. ;

Davis, Garvin H. ;

Kellaway, Judianne .

JOURNAL OF AAPOS, 2015, 19 (02) :119-123

[4]

Childrens Safety Network, 2023, Non-fatal traumatic brain injury-related visits to the emergency department, U.S. Infants, children

[5] Occult abusive injuries in infants with apparently isolated skull fractures [J].

Deye, Katherine P. ;

Berger, Rachel P. ;

Lindberg, Daniel M. .

JOURNAL OF TRAUMA AND ACUTE CARE SURGERY, 2013, 74 (06) :1553-1558

[6] Selective Skeletal Surveys for Infants With Skull Fractures Examining the Rates of Return to Medical Care for Concern of Physical Abuse [J].

Dominguez, Michelle M. ;

Moore, Jessica L. ;

Cook, Megan ;

Rogers, Michelle L. ;

McCarten, Kathleen ;

Slingsby, Brett .

PEDIATRIC EMERGENCY CARE, 2022, 38 (12) :E1678-E1683

[7]

Edgoose Jennifer Y C, 2019, Fam Pract Manag, V26, P29

[8] BIAS REDUCTION OF MAXIMUM-LIKELIHOOD-ESTIMATES [J].

FIRTH, D .

BIOMETRIKA, 1993, 80 (01) :27-38

[9] Implicit bias in healthcare professionals: a systematic review [J].

FitzGerald, Chloe ;

Hurst, Samia .

BMC MEDICAL ETHICS, 2017, 18

[10] The REDCap consortium: Building an international community of software platform partners [J].

Harris, Paul A. ;

Taylor, Robert ;

Minor, Brenda L. ;

Elliott, Veida ;

Fernandez, Michelle ;

O'Neal, Lindsay ;

McLeod, Laura ;

Delacqua, Giovanni ;

Delacqua, Francesco ;

Kirby, Jacqueline ;

Duda, Stephany N. .

JOURNAL OF BIOMEDICAL INFORMATICS, 2019, 95

← 1 2 3 4 →