Clues that aid in the diagnosis of nonaccidental trauma presenting as an apparent life-threatening event

Kishore Vellody, Jennifer P. Freeto, Sandra L. Gage, Nicole Collins, William M. Gershan

Research output: Contribution to journalArticlepeer-review

22 Scopus citations

Abstract

Background: Apparent life-threatening events (ALTEs) can encompass many different diagnoses. Nonaccidental trauma (NAT) is one potential serious diagnosis. Objective: (1) To identify key elements in the history and physical exam in infants presenting with an ALTE that aid in the subsequent diagnosis of NAT; and (2) to evaluate the role of diagnostic studies in these infants in confirming the diagnosis of NAT. Design/Methods: A retrospective chart review analysis, over a 2-year period, of infants with an ALTE was performed. From this group, all children with a discharge diagnosis of child physical abuse, shaken infant syndrome, or NAT were included in the study. Results: 4 patients were found to be victims of NAT based on their clinical histories and physical examinations. Although confirmatory, ophthalmologic exams, skeletal surveys, and head CT scans had a lower sensitivity for NAT. Conclusions: NAT should be considered when an infant is admitted for evaluation of an ALTE.

Original languageEnglish (US)
Pages (from-to)912-918
Number of pages7
JournalClinical Pediatrics
Volume47
Issue number9
DOIs
StatePublished - Nov 1 2008

Keywords

  • Apparent life-threatening events
  • Child abuse
  • Nonaccidental trauma

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