Document Detail

Should child abuse and neglect be considered when a child dies unexpectedly?
MedLine Citation:
PMID:  4036919     Owner:  NLM     Status:  MEDLINE    
Deaths during two years at a pediatric teaching hospital were studied to develop guidelines for clinicians who must decide when to explore the possibility of child abuse or neglect when a child dies unexpectedly. Unexpected deaths were defined as deaths occurring before arrival at the hospital or within ten days of hospitalization in children past the first month of life and unrelated to any previously known congenital anomaly or medical condition. There were 43 such deaths during two years. The majority (27) were due to natural causes. However, nine deaths were related to suspected child abuse or neglect (SCAN) and in three of those cases evidence of injury was found only at autopsy. The SCAN cases were more often mistaken for medical illness than for uninflicted injury, indicating that autopsy and postmortem skeletal survey are warranted whenever a child dies unexpectedly. The two factors "dead on arrival" and "1 year of age or less" had a positive predictive value for SCAN of 89% and a negative predictive value of 94%. The two factors identify a high-risk group requiring at least hospital-based investigation into the possibility of abuse or neglect. Reporting for SCAN is warranted when unsuspected trauma is found post mortem, there is direct physical or social evidence of child abuse or neglect, or the child is in the high-risk group and hospital-based investigation falls to eliminate the possibility that maltreatment contributed to the child's death.
K K Christoffel; E J Zieserl; J Chiaramonte
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  American journal of diseases of children (1960)     Volume:  139     ISSN:  0002-922X     ISO Abbreviation:  Am. J. Dis. Child.     Publication Date:  1985 Sep 
Date Detail:
Created Date:  1985-10-03     Completed Date:  1985-10-03     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0370471     Medline TA:  Am J Dis Child     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  876-80     Citation Subset:  AIM; IM    
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MeSH Terms
Child Abuse*
Child, Preschool
Death, Sudden / etiology*
Hospitals, Pediatric
Sudden Infant Death / diagnosis,  etiology

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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