TY  - JOUR
PY  - 2016//
TI  - Abusive head trauma in Turkey and impact of multidisciplinary team establishment efforts on case finding and management: preliminary findings
JO  - Eurasian journal of emergency medicine
A1  - Yaylaci, Serpil
A1  - Dallar, Yildiz
A1  - Sayar, Yavuz
A1  - Taşar, Medine Ayşin
A1  - Tiras, Ulku
A1  - Tekin, Deniz
A1  - Unlu, Agahan
A1  - Ulukol, Betul
A1  - Yucel Beyaztas, Fatma
A1  - Butun, Celal
A1  - Ozum, Unal
A1  - Buken, Bora
A1  - Kandemir, Ferhan
A1  - Gokoglu, Ahmet
A1  - Kondolot, Meda
A1  - Menku, Ahmet
A1  - Patiroglu, Turkan
A1  - Tunc, Aydin
A1  - Yagmur, Fatih
A1  - Yikilmaz, Ali
A1  - Akar, Taner
A1  - Beyazova, Ufuk
A1  - Degirmenci, Bulent
A1  - Iseri, Elvan
A1  - Sahın, Figen
A1  - Baransel Isir, Aysun
A1  - Bilen, Ayse Gul
A1  - Oral, Resmiye
A1  - Gazioglu, Nurperi
A1  - Balci, Yasemin
A1  - Eryuruk, Mesut
A1  - Karagoz, Feyza
SP  - 24
EP  - 29
VL  - 15
IS  - 1
N2  - AIM: Abusive head trauma (AHT) is the most common cause of death as the result of child abuse. A task force is planned to provide training on AHT to professionals in different disciplines on clinical presentation, diagnostic workup, and organization of multidisciplinary evaluation at the hospital and community levels. This study reports on the preliminary findings of the pre-intervention phase of a larger study.     Materials and Methods: This is a descriptive, retrospective study exploring the rates of documentation of relevant data in charts, including risk factors for abuse, family demographics, completeness of diagnostic workup, and case finding.     Results: Overall, 345 cases were found in hospital databases that were eligible for the retrospective study from 10 participating hospitals. In total, 305 cases (88.4%) were younger than 2 years of age. The most common documented risk factors were low parental education level in 82 families (23.8%), more than three children under 7 years of age in 76 families (22.0%), and bad child temper in 16 families (4.6%), among others. The rate of complete diagnostic workup in hospitals with a multidisciplinary team (MDT) (25.7%) was statistically significantly higher than in hospitals without an MDT (2.9%) (p=0.001). Etiology was identified as inflicted in 78 cases (22.6%), possibly inflicted in 24 (7.0%), undetermined in 79 (22.9%), and accidental in 164 (47.5%) by the researchers, compared to only three cases (0.8%) diagnosed as inflicted by the treating physicians (p<0.0001). In two of the three cases, the perpetrator was convicted; in one, the prosecutor closed the case without a trial on the basis of "no confession" despite the death of the child and medical evidence.     Conclusion: Clinicians' knowledge of the diagnosis of AHT should be increased to improve case finding, which will allow determination of more accurate incidence/prevalence. This can be accomplished via the establishment of an MDT in teaching hospitals as well as staff training on how to recognize suspicious cases, how to utilize MDT services, and how to report and manage cases on a community level multidisciplinary basis.<p />  <p>Language: en</p>
LA  - en
SN  - 2149-5807
UR  - http://dx.doi.org/10.5152/eajem.2016.52386
ID  - ref1
ER  -