Oral injuries in children less than 24 months of age in a pediatric emergency department |
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| Institution: | 1. Department of Pediatrics, Section of Emergency Medicine, Yale University School of Medicine, 100 York Street, Suite 1F, New Haven, Connecticut, 06511, USA;2. Department of Pediatrics, Section of General Pediatrics, Yale University School of Medicine, Dana Clinic Building Basement, 789 Howard Avenue, New Haven, Connecticut, 06519, USA;1. St Christopher''s Hospital for Children, Philadelphia, PA 19134, USA;2. Children''s Mercy Hospitals and Clinics, Kansas City, MO, USA;3. Boston Medical Cente, Boston, MA, USA;1. Department of Social Psychology, Sookmyung Women''s University, Yongsan-gu, Chungpa-ro 47 Gil 100, Seoul, 04310, Republic of Korea;2. Seoul Metropolitan Police Agency, 31 Sajik-no 8Gil, Jongro-gu, Seoul, 03169, Republic of Korea;1. Children''s Physician Services of South Texas, Driscoll Children''s Hospital, Corpus Christi, TX;2. Children''s Protection Program, Odessa Brown Children''s Clinic, Seattle Children''s Hospital, University of Washington;3. Seattle Children''s Hospital, University of Washington, Seattle, WA;4. Division of Child Abuse and Neglect, Children''s Mercy Hospital, UMKC School of Medicine, Kansas City, MO;5. Department of Emergency Medicine, University of Colorado School of Medicine, Aurora, CO;6. Kempe Center for the Prevention and Treatment of Child Abuse, Department of Pediatrics, Children''s Hospital of Colorado, Aurora, CO |
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| Abstract: | BackgroundOral injuries in young children may indicate physical abuse. The prevalence of oral injuries in young children presenting to the emergency department is unknown. These data would assist providers in making decisions about the need for further abuse evaluation.ObjectiveTo determine the prevalence of oral injuries, associated chief complaints and characteristics, and frequency of abuse evaluations in children younger than 24 months presenting to a pediatric emergency department (PED). Participants and Setting: Twelve pediatric emergency medicine physicians consecutively enrolled children younger than 24 months in a tertiary care PED.MethodsWe performed a prospective observational study. Enrolled patients underwent a complete oral examination. Providers recorded patient demographics, type of chief complaint, oral injury details, developmental ability, and the presence of an abuse evaluation.ResultsOral injuries occurred in 36/1303 (2.8%, 95% CI 1.9–3.8%) and were more common in patients with traumatic (26/200, 13%) versus medical chief complaints (10/1,103, 0.9%) (p < .001). Of patients with oral injuries (36), 78% were mobile and 72% had traumatic chief complaints. Nine (25%) children with oral injuries were evaluated for abuse. Oral injuries in children 0–11 months old were more likely to be evaluated for abuse than children 12–24 months old (70.0% vs. 7.7%, p < .001).ConclusionsThe prevalence of oral injuries in children <24 months old presenting to a PED was low. Most occurred in mobile children and in children with traumatic chief complaints. Younger, non-mobile children with oral injuries had a higher likelihood of having an abuse evaluation. |
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| Keywords: | Child abuse Pediatric trauma Sentinel injury Oral injury Emergency medicine |
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