与儿童保护服务相关的因素 在幼儿中与孤立的头骨骨折相关的推
Karli Breeden-Carino1, Joanne N Wood2, Cindy W Christian3
1Division of General Pediatrics, Children's Hospital of Philadelphia, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA 19104.
Academic pediatrics
|December 3, 2025
概括
许多头骨骨折的幼儿被转介给儿童保护服务 (CPS),即使虐待的可能性很低. 心理社会风险和医院所在地等因素影响CPS转诊,在各机构中显示出显著的差异.
科学领域:
- 儿科创伤学 儿科创伤学
- 儿童虐待 儿科 儿科
- 法医儿科医生 法医儿科医生
背景情况:
- 患有孤立头骨骨折的幼儿通常会被转介给儿童保护服务 (CPS).
- 这些转诊发生,尽管评估表明滥用可能性很低.
- 在不同医院的CPS转诊实践中存在显著的差异.
研究的目的:
- 确定与患有孤立头骨骨折的幼儿中CPS转诊相关的因素.
- 量化医疗保健机构转诊率在医院一级的变化.
- 在儿童头骨骨折的情况下,为适当的CPS转诊提供指导方针.
主要方法:
- 对2岁以下头骨骨折的儿童进行多中心回顾性横截面研究.
- 包括有或没有内出血 (ICH) 和没有其他伤害的儿童,他们接受了儿童虐待儿科 (CAP) 评估.
- 使用多变量后勤回归和边际标准化来分析CPS转诊因子和医院变异.
主要成果:
- 在528名儿童中,超过一半 (57.4%) 被转介到CPS,大多数是在CAP咨询之前 (86.5%).
- 与CPS转诊相关的因素包括心理社会风险因素,亲自CAP咨询,造成或没有创伤史,没有ICH和医院地点.
- 调整后的CPS转诊率在各医院之间差异很大,从34.6%到76.4%不等.
结论:
- 根据医院的位置,儿童头骨骨折的CPS转诊情况存在两倍的变化.
- 大多数CPS转诊发生在儿童虐待专家儿科咨询之前.
- 调查结果突出了在这些情况下对CPS转诊的指示的标准化指导的需要.
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