Journal article
Disability and visual outcomes following suspected abusive head trauma in children under 2 years
- Abstract:
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Aim To report disability and visual outcomes following suspected abusive head trauma (AHT) in children under 2 years.
Methods We present a retrospective case series (1995–2017) of children with suspected AHT aged ≤24 months. King’s Outcome Score of Childhood Head Injury (KOSCHI) was used to assess disability outcomes at hospital discharge and at follow-up. The study used a retinal haemorrhage score (RHS) to record findings at presentation and a visual outcome score at follow-up.
Results We included 44 children (median age 16 weeks). At presentation, 98% had a subdural haemorrhage and 93% had a retinal haemorrhage. At discharge, 61% had moderate-to-severe disability, and 34% a good recovery. A higher RHS was observed in those with more disability (r=−0.54, p=0.0002). At follow-up, 14% had a worse KOSCHI score (p=0.055). 35% children had visual impairment, including 9% with no functional vision. Those with poorer visual function had a higher RHS (r=0.53, p=0.003). 28% attended mainstream school without support; 50% were in foster care or had been adopted, 32% lived with birth mother and 18% with extended family.
Conclusion It is known that injuries from suspected AHT result in high levels of morbidity; our cohort showed significant rates of disability and visual impairment. Those with higher disability at discharge and poorer visual function showed more significant retinal changes. The extent of disability was not always apparent at hospital discharge, impacting on provision of prognostic information and targeted follow-up.
- Publication status:
- Published
- Peer review status:
- Peer reviewed
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- Files:
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(Preview, Accepted manuscript, pdf, 251.7KB, Terms of use)
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- Publisher copy:
- 10.1136/archdischild-2019-318638
Authors
- Publisher:
- BMJ Publishing Group
- Journal:
- Archives of Disease in Childhood More from this journal
- Volume:
- 106
- Issue:
- 6
- Pages:
- 590-593
- Publication date:
- 2020-07-14
- Acceptance date:
- 2020-06-12
- DOI:
- EISSN:
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1468-2044
- ISSN:
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0003-9888
- Language:
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English
- Keywords:
- Pubs id:
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1115495
- Local pid:
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pubs:1115495
- Deposit date:
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2020-07-02
- ARK identifier:
Terms of use
- Copyright holder:
- Wright et al.
- Copyright date:
- 2020
- Notes:
- This is the accepted manuscript version of the article. The final version is available online from BMJ Publishing Group at https://doi.org/10.1136/archdischild-2019-318638
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