Wells et al identified certain findings seen on computed tomographic (CT) scans that are associated with intentional head injury in children less than 3 years of age. The authors are from Milwaukee and Singapore.
Findings associated with intentional injury:
(1) hygroma
(2) convexity subdural hematoma without hygroma
(3) absence of fracture
(4) inter-hemispheric subdural hematoma
|
Risk Factor |
Odds Ratio |
95% Confidence Interval |
|
hygroma |
47.4 |
7.6 to infinity |
|
convexity subdural hematoma without hygroma |
4.4 |
1.9 to 10.2 |
|
absence of fracture |
4.3 |
2.0 to 9.5 |
|
inter-hemispheric subdural hematoma |
3.7 |
1.7 to 8.2 |
from Table 4, page 255
|
Parameter |
Finding |
Points |
|
hygroma |
absent |
0 |
|
|
present |
1 |
|
convexity subdural hematoma without hygroma |
absent |
0 |
|
|
present |
1 |
|
fracture |
present |
0 |
|
|
absent |
1 |
|
inter-hemispheric subdural hematoma |
absent |
0 |
|
|
present |
1 |
X =
= (3.86 * (points for hygroma)) + (1.47 * (points for convexity subdural hematoma)) + (1.46 * (points for fracture)) + (1.32 * (points for inter-hemispheric subdural hematoma)) – 1.66
probability of intentional injury =
= 1 / (1 + EXP((-1) * X))
Performance:
• Using a cutoff of 45%, the sensitivity for intentional injury is 84% with a specificity of 83%.
Specialty: Clinical Laboratory, Emergency Medicine, Pedatrics
ICD-10: ,
