TY  - JOUR
PY  - 2023//
TI  - Yield of postmortem skeletal surveys in infants presenting to emergency care with sudden and unexpected death
JO  - Pediatric emergency care
A1  - Henry, M. Katherine
A1  - Egbe, Teniola I.
A1  - White, Ammie M.
A1  - Servaes, Sabah
A1  - Andronikou, Savvas
A1  - Scribano, Philip V.
A1  - Wood, Joanne N.
SP  - ePub
EP  - ePub
VL  - ePub
IS  - ePub
N2  - OBJECTIVES: Child abuse should be considered in cases of sudden unexpected infant death (SUID). Postmortem skeletal surveys (PM-SS) are recommended to evaluate for abusive fractures in SUID. Little is known about the yield of PM-SS among infants presenting to emergency care with SUID. Our objectives were to (1) describe the presentation and care of infants with SUID at a tertiary children's hospital emergency department and (2) report PM-SS use and findings. <br><br>METHODS: We performed a retrospective study of infants younger than 12 months with SUID presenting to an urban emergency department from 2007 to 2019. We describe their presentation and care, including PM-SS performance and findings, referrals to the medical examiner, and reports to child protective services (CPS). We assessed for associations between race, payer, and presentation with reports to CPS. <br><br>RESULTS: Of 73 infants with SUID, concern for unsafe sleep was documented in 45 (61.6%) and 71 (97.3%) underwent cardiopulmonary resuscitation by a medical professional. All 73 (100%) underwent PM-SS and were referred to the medical examiner. Twelve definite fractures (11 rib, 1 classic metaphyseal lesion) and 8 possible fractures (7 rib, 1 classic metaphyseal lesion) were identified among 6 (8.2%) infants. Forty-three (58.9%) were reported to CPS. There were no associations between race, payer, age, or history of unsafe sleep and CPS reports. <br><br>CONCLUSIONS: One in 12 cases of SUID had a possible and/or definite fracture identified on plain radiography. Multicenter studies are needed to compare yield across different postmortem imaging modalities and populations.<p />  <p>Language: en</p>
LA  - en
SN  - 0749-5161
UR  - http://dx.doi.org/10.1097/PEC.0000000000003013
ID  - ref1
ER  -