@article{ref1,
title="Evidence-based screening to optimize the yield of positive ophthalmologic examinations in children evaluated for suspected child abuse",
journal="Journal of Pediatric Ophthalmology and Strabismus",
year="2022",
author="Su, Maxwell and Taylor, Kirby and Stoutin, Jaqueline and Shaver, Courtney and Recko, Matthew",
volume="ePub",
number="ePub",
pages="ePub-ePub",
abstract="PURPOSE: To determine nonocular findings associated with significant retinal hemorrhage on dilated fundus examination in cases of suspected child abuse. <br><br>METHODS: This was a retrospective chart review from May 2014 to August 2021 at a level-1 trauma center. Two hundred seventy-four patients met the following inclusion criteria: (1) children 36 months and younger; (2) concern for child abuse; and (3) had an ophthalmology consultation. Through univariate and multivariate logistic regression, the study produced a screening algorithm for ophthalmic work-up in child abuse. <br><br>RESULTS: One or more abnormal neuroimaging findings had a statistically significant association with retinal hemorrhages and produced the strongest association with a univariate odds ratio of 170 (confidence interval: 10.245 to > 999.999). The multivariate model (P <.0001 with a c-statistic of 0.980) proposes using the following variables for predicting retinal hemorrhage on examination: abnormal neuroimaging, Glasgow Coma Scale score less than 15, altered mental status on examination, seizure activity, vomiting, bruising, scalp hematoma/swelling, and skull fractures. <br><br>CONCLUSIONS: This study elucidates clinical and imaging factors that correlate to retinal findings, validating previously studied variables and introducing new variables to be considered. The authors propose an evidence-based screening algorithm to increase the yield of positive dilated examinations and decrease the burden of potentially unnecessary child abuse ophthalmologic examinations. [J Pediatr Ophthalmol Strabismus. 20XX;XX(X):XX-XX.].<p /> <p>Language: en</p>",
language="en",
issn="0191-3913",
doi="10.3928/01913913-20220216-01",
url="http://dx.doi.org/10.3928/01913913-20220216-01"
}