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International Conference on
FAMILY MEDICINE AND FAMILY PHYSICIANS
October 16-17, 2017 | Toronto, Canada
Arch Gen Intern Med 2017 | Volume 1 Issue 3
Abusive vs non-abusive head injury in children: A systematic review
Shalea J Piteau
Queen’s University, Canada
Context & Objective:
To systematically review the literature
to determine which clinical and radiographic characteristics
are associated with abusive head trauma (AHT) and non-
abusive head trauma (nAHT) in children?
Data Sources:
We searched Medline, Embase, PubMed,
conference proceedings and reference lists to identify
relevant studies. Study Selection & Data Extraction: Two
reviewers independently selected studies that compared
clinical and/or radiographic characteristics including
historical features, physical exam and imaging findings and
presenting signs or symptoms in hospitalized children less
than or equal to six years of age with AHT and nAHT.
Results:
Twenty-four studies were included. Meta-analysis was
complicatedby inconsistencies inthereportingof characteristics
and high statistical heterogeneity. Notwithstanding these
limitations, there were 19 clinical and radiographic variables
that could be meta-analysed and odds ratios were determined
for each variable. In examining only studies deemed to be high
quality, we found that subdural haemorrhage (s), cerebral
ischemia; retinal haemorrhage (s), skull fracture (s) plus
intracranial injury, metaphysical fracture (s), long bone fracture
(s), rib fracture (s), seizure (s), apnoea, and no adequate
history given were significantly associated with AHT. Epidural
haemorrhage (s), scalp swelling, and isolated skull fracture
(s) were significantly associated with nAHT. Sub-arachnoid
haemorrhage (s), diffuse axonal injury, cerebral oedema,
head and neck bruising, any bruising, and vomiting, were not
significantly associated with either type of trauma.
Conclusions:
Clinical and radiographic characteristics associated
with AHT and nAHT were identified, despite limitations in
the literature. This systematic review also highlights the need
for consistent criteria in identifying and reporting clinical and
radiographic characteristics associated with AHT and nAHT.
Speaker Biography
Shalea Piteau is the Chief/Medical Director of Pediatrics at Quinte Health Care and
an Assistant Professor at Queen’s University. She went to Queen’s University and
graduated with a Bachelor of Science Honors Degree, and then she did a Masters
of Science in Physiology at the University of British Columbia (UBC). Shalea went to
Medical School at UBC and then she completed a Residency in Pediatrics at Queen’s
University. She enjoys doing on missionary work, and has done missions in various
places including Africa, Asia, South and Central America, and the Native Reserves in
northern Canada.
e:
shaleapiteau@gmail.com