000 03130nab a22003737a 4500
999 _c9107
_d9107
005 20250625151721.0
008 250116s2024 -nz||||| |||| 00| 0 eng d
040 _aAFVC
082 _a362.7 KEL
100 _aKelly, Patrick
_91477
245 _aFactors associated with decisions to refer possible abusive head trauma to a hospital-based child protection team in Aotearoa New Zealand
_cPatrick Kelly, Joanne Knappstein, Natalie Durup and Peter Reed
260 _c2024
_aElsevier,
500 _aChild Abuse & Neglect, 2024, 158: 107142
520 _aBackground Aotearoa New Zealand has a high incidence of abusive head trauma (AHT) and a national children's hospital with an established multi-disciplinary child protection team (CPT). Staff concerned about possible AHT are expected to refer to the CPT, but there has been no research into the factors which might influence those referral decisions. Objective To identify factors associated with decisions to refer head-injured children to the CPT, and to assess whether those factors are consistent with the literature. Participants and setting All children <5 years old admitted from 2010 to 2019 with skull fracture or intracranial injury. Methods Retrospective review comparing 25 variables in cases referred and not referred. Multivariable analysis estimated the independent role of each variable and modelled their combined contribution to decisions to refer. The area under the receiver operator characteristic curve (AUROC) and 95 % CI were used to describe performance of the model. Results Of 631 head-injured children, 265 (42 %) were referred and 121 (19 %) diagnosed as AHT/undetermined. Variables associated with referral decisions were age < 1 year, p = .0001; injury inconsistent with the history, p < .0001; certain categories of history (motor vehicle accident, no history, history of abuse, fall <1 m, blunt force and penetrating trauma), p < .0001; delayed presentation, p < .0001; past history of injury, p = .0001; social/behavioral concerns, p < .0001 and subdural hemorrhage, p = .01. The AUROC was 0.95 (95 % CI 0.93, 0.97). Conclusions Factors associated with referral are generally consistent with the literature. The percentage referred seems justified given the number diagnosed as AHT/undetermined. (Authors' abstract). Record #9107
650 0 _97583
_aABUSIVE HEAD TRAUMA
650 0 _aĀRAI WHATITATA
_95546
650 0 _aCHILD ABUSE
_9103
650 0 _aCHILD PROTECTION
_9118
650 0 _aDATA ANALYSIS
_9181
650 0 _aHAUORA
_9281
650 0 _aHEALTH SERVICES
_9290
650 0 _aPATU TAMARIKI
_95534
650 0 _aRISK FACTORS
_9505
650 0 _aTATAURANGA
_9598
650 0 _aTRAUMATIC BRAIN INJURY
_93258
651 4 _aNEW ZEALAND
_92588
700 _aKnappstein, Joanne
_913678
700 _aDurup, Natalie
_913679
700 _aReed, Peter
_92994
773 0 _tChild Abuse & Neglect, 2024, 158: 107142
830 _aChild Abuse & Neglect
_94477
856 _uhttps://doi.org/10.1016/j.chiabu.2024.107142
_zDOI: 10.1016/j.chiabu.2024.107142 (Open access)
942 _2ddc
_cARTICLE
_hnews132