Title

Delay in Arrival to Care in Perpetrator-Identified Nonaccidental Head Trauma: Observations and Outcomes

Publication Date

2015

Journal Title

World Neurosurg

Abstract

BACKGROUND: Children who sustained nonaccidental head trauma (NAHT) are at severe risk for mortality within the first 24 hours after presentation. OBJECTIVE: Extent of delay in seeking medical attention may be related to patient outcome. METHODS: A 10-year, single-institution, retrospective review of 48 cases treated at a large tertiary Children's Hospital reported to the New York State Central Registrar by the child protection team was conducted. The perpetrator was identified in 28 cases on the basis of confession or conviction. The medical and legal records allowed for identification of time of injury and the interval between injury and arrival to the hospital; this information was categorized as follows:(without delay); 6-12 hours (moderate delay); and >12 hours (severe delay). The King's Outcome Scale for Childhood Head Injury (KOSCHI) score was recorded for each case. RESULTS: All children were 3 years of age or younger (2.1-34 months) and predominantly male (68%; 19/28). On arrival, 61% of patients (17/28) presented with moderate or severe delay. A low arrival Glasgow Coma Scale (GCS) score (P < 0.0001) and extracranial injuries (P < 0.0061) correlated with worse clinical patient outcomes. Patients with an arrival GCS score

Volume Number

84

Issue Number

5

Pages

1340-6

Document Type

Article

EPub Date

2015/06/30

Status

Faculty; Northwell Researcher

Facility

School of Medicine; Northwell Health

Primary Department

Neurosurgery

PMID

26118721

DOI

10.1016/j.wneu.2015.06.023