Pediatrics open science最新文献

{"title":"Occult Abdominal Trauma Screening in the Evaluation of Suspected Child Physical Abuse.","authors":"Tagrid M Ruiz-Maldonado, Joanne N Wood, Antoinette L Laskey, Christopher S Greeley, Angela Bachim, Daniel M Lindberg, James Anderst, John Melville, Carmen Coombs, Nancy S Harper, Lori Frasier, Farah W Brink, Caitlin E Crumm, Kristine A Campbell","doi":"10.1542/pedsos.2024-000274","DOIUrl":"10.1542/pedsos.2024-000274","url":null,"abstract":"<p><strong>Background and objectives: </strong>Occult abdominal trauma (OAT) screening with transaminases, followed by abdominal computed tomography (CT) for transaminase values greater than 80 IU/L, has been recommended in cases of suspected physical abuse. This study aimed to evaluate case characteristics associated with OAT evaluation and determine OAT prevalence in these children.</p><p><strong>Methods: </strong>Injured children aged younger than 60 months undergoing Child Abuse Pediatrics (CAP) consultation for suspected physical abuse from February 2021 to May 2023 were identified in CAPNET, a multicenter research network. Children with symptoms or signs of intra-abdominal injury were excluded. We identified case characteristics associated with transaminase screening and abdominal CT imaging using logistic regression and determined OAT prevalence.</p><p><strong>Results: </strong>Of 6161 eligible children, 3982 (64.6%) underwent transaminase screening; 687/3982 (17.3%) had transaminases greater than 80 IU/L with 298/687 (43.4%) undergoing abdominal CT imaging. Variability in screening and imaging practices was identified between CAPNET sites. In a fully adjusted model, transaminase screening was associated with ages younger than 6 months, greater clinical severity, and site. CT imaging was associated with site, inpatient status, and higher transaminase range. We identified 16 OAT cases in children with transaminases greater than 80 IU/L, representing 2.3% of CAP-evaluated children with positive transaminase screening and 0.3% of all eligible children.</p><p><strong>Conclusions: </strong>Providers often perform transaminase screening but not abdominal CT imaging despite transaminases greater than 80 IU/L. The low prevalence of OAT suggests that routine transaminase screening in suspected child physical abuse evaluations may not be necessary when all signs and symptoms of abdominal injury are absent.</p>","PeriodicalId":520527,"journal":{"name":"Pediatrics open science","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12270396/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144661699","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}