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