Performance of a Clinical Prediction Rule for Pediatric Abusive Head Trauma

A four-variable clinical prediction rule identified 98% of infants and children with discharge diagnoses of abusive head trauma.

Investigators prospectively evaluated the performance of a clinical prediction rule for identifying abusive head injury in patients <3 years of age admitted to a pediatric intensive care unit (PICU) for closed head injury. The rule, which had a sensitivity of 96% and specificity of 36% in the derivation cohort, consists of four variables:

Clinically significant respiratory compromise (infrequent or labored respirations, apnea, or need for assisted ventilation)
Bruising involving the ears, neck, or torso
Subdural hemorrhages or bilateral or interhemispheric fluid collections
Skull fractures (other than isolated linear/parietal)

Of 291 patients (median age, 6 months) admitted during 1 year to one of 14 PICUs participating in the Pediatric Brain In…

Reviewing Author

Katherine Bakes, MD

Disclosures

RoyaltiesEmergency Medicine Secrets (Elsevier)

Grant/Research SupportDepartment of Justice

Editorial BoardsEmergency Medicine Secrets (Elsevier); Rosen’s Emergency Medicine (Elsevier)

Katherine Bakes, MD

Disclosures

RoyaltiesEmergency Medicine Secrets (Elsevier)

Grant/Research SupportDepartment of Justice

Editorial BoardsEmergency Medicine Secrets (Elsevier); Rosen’s Emergency Medicine (Elsevier)

Performance of a Clinical Prediction Rule for Pediatric Abusive Head Trauma

Topics

Reviewing Author