TY  - JOUR
PY  - 2014//
TI  - Additional injuries in young infants with concern for abuse and apparently isolated bruises
JO  - Journal of pediatrics
A1  - Harper, Nancy S.
A1  - Feldman, Kenneth W.
A1  - Sugar, Naomi F.
A1  - Anderst, James D.
A1  - Lindberg, Daniel M.
SP  - 383
EP  - 388.e1
VL  - 165
IS  - 2
N2  - OBJECTIVE: To determine the prevalence of additional injuries or bleeding disorders in a large population of young infants evaluated for abuse because of apparently isolated bruising. STUDY DESIGN: This was a prospectively planned secondary analysis of an observational study of children <10 years (120 months) of age evaluated for possible physical abuse by 20 US child abuse teams. This analysis included infants <6 months of age with apparently isolated bruising who underwent diagnostic testing for additional injuries or bleeding disorders. <br><br>RESULTS: Among 2890 children, 33.9% (980/2890) were <6 months old, and 25.9% (254/980) of these had bruises identified. Within this group, 57.5% (146/254) had apparently isolated bruises at presentation. Skeletal surveys identified new injury in 23.3% (34/146), neuroimaging identified new injury in 27.4% (40/146), and abdominal injury was identified in 2.7% (4/146). Overall, 50% (73/146) had at least one additional serious injury. Although testing for bleeding disorders was performed in 70.5% (103/146), no bleeding disorders were identified. Ultimately, 50% (73/146) had a high perceived likelihood of abuse. <br><br>CONCLUSIONS: Infants younger than 6 months of age with bruising prompting subspecialty consultation for abuse have a high risk of additional serious injuries. Routine medical evaluation for young infants with bruises and concern for physical abuse should include physical examination, skeletal survey, neuroimaging, and abdominal injury screening.<p />  <p>Language: en</p>
LA  - en
SN  - 0022-3476
UR  - http://dx.doi.org/10.1016/j.jpeds.2014.04.004
ID  - ref1
ER  -