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Occult Injury Screening Among Infants With Subconjunctival Hemorrhage
Insights
Screening for occult injuries in infants with subconjunctival hemorrhages (SCH) was infrequent, though more common with additional injuries. Occult injuries were often found when screening occurred, suggesting underdiagnosis in infants with SCH.
Area of Science:
- Pediatric Medicine
- Ophthalmology
- Child Abuse & Neglect
Background:
- Subconjunctival hemorrhages (SCH) in infants can be associated with abusive head trauma.
- Screening for occult injuries is crucial in evaluating infants with SCH.
Purpose of the Study:
- To determine the frequency and nature of occult injury screening in infants with SCH.
- To investigate the incidence of occult injuries in this population.
- To identify factors influencing screening decisions for additional injuries.
Main Methods:
- Retrospective chart review of 84 infants (14 days to 6 months) with SCH at two pediatric centers.
- Stratification into groups based on the presence of additional mucocutaneous injuries.
- Comparison of screening rates and outcomes between groups.
Main Results:
- Skeletal surveys were performed in 31% of infants overall.
- Screening rates were significantly higher in infants with SCH and additional mucocutaneous injuries compared to SCH alone.
- Additional mucocutaneous injuries did not correlate with an increased risk of positive skeletal surveys.
Conclusions:
- Occult injury screening rates in infants with SCH are low.
- The decision to screen was significantly influenced by the presence of additional injuries.
- Occult injuries were frequently identified when screening was performed, indicating potential underdiagnosis.
Purpose:
To assess the frequency and nature of occult injury screening in infants with subconjunctival hemorrhages (SCH), the incidence of occult injuries in these children, and the factors that may have influenced the decision to screen for additional injury.
Methods:
Infants aged 14 days to 6 months with SCH who presented to two tertiary pediatric centers were identified from a local database (N = 84). A retrospective chart review collected demographics, examination findings, and imaging results. Infants were further stratified into two groups depending on the presence of additional mucocutaneous injuries. The groups were compared with two-sample t testing.
Results:
Skeletal surveys were completed in 31% of patients overall, but the rate of screening was significantly higher among patients who presented with SCH and additional mucocutaneous injuries as opposed to SCH alone. However, the presence of additional mucocutaneous injuries was not associated with an increased risk for positive skeletal survey.
Conclusions:
Rates of occult injury screening among infants with SCH were low and were significantly influenced by the presence of additional injuries. When screening was conducted, occult injuries were commonly identified. Future studies should assess the true prevalence of abuse in this population. [.
