Abstract：
OBJECTIVE: Shaken baby syndrome (SBS), a subset of abusive head trauma, results from non-accidental, violent head shaking. Most survivors suffer permanent neurological sequelae. Accurate diagnosis is imperative and remains challenging. The purpose of this study is to describe ocular injuries and associated neurotrauma in suspected SBS.
METHODS: We retrospectively surveyed the National Trauma Data Bank 2008-2014 for patients ≤ 3 years old admitted for suspected SBS. Statistical analysis was performed with SPSS software. Significance was set at p < 0.05.
RESULTS: Three hundred forty-seven (13.9%) of 2495 patients who were ≤ 3 years old were admitted with abusive head trauma and ocular injuries which resulted from suspected SBS. Most were < 1 year old (87.9%) and male (54.2%). Common eye injuries were retinal hemorrhages (30.5%), eye/adnexa contusion (14.7%), and retinal edema (10.7%). Common neurotrauma were subdural (75.5%), subarachnoid (23.9%), and intracerebral hemorrhage (ICH) (10.4%). Mean (SD) Injury Severity Score was severe, 20.2 (8.2), and Glasgow Coma Score was moderate, 9.2 (12.8). The mortality rate was 16.7%. Retinal hemorrhages were not significantly associated with one type of neurotrauma over others. Ocular/adnexa contusion (OR 4.06; p < 0.001) and commotio retinae/Berlin\'s edema (OR 5.27; p < 0.001) had the greatest association with ICH than other neurotrauma. Optic neuropathy (OR 21.33; p < 0.001) and ICH (OR 3.34; p < 0.001) had the highest associated with mortality.
CONCLUSIONS: Our study supports previous studies showing that retinal and subdural hemorrhages were the most common ocular injury and neurotrauma in SBS, respectively. However, we did not find a significant propensity for their concurrence. Commotio retinae/Berlin\'s edema was significantly associated with both intracerebral and subdural hemorrhages.
METHODS: We retrospectively surveyed the National Trauma Data Bank 2008-2014 for patients ≤ 3 years old admitted for suspected SBS. Statistical analysis was performed with SPSS software. Significance was set at p < 0.05.
RESULTS: Three hundred forty-seven (13.9%) of 2495 patients who were ≤ 3 years old were admitted with abusive head trauma and ocular injuries which resulted from suspected SBS. Most were < 1 year old (87.9%) and male (54.2%). Common eye injuries were retinal hemorrhages (30.5%), eye/adnexa contusion (14.7%), and retinal edema (10.7%). Common neurotrauma were subdural (75.5%), subarachnoid (23.9%), and intracerebral hemorrhage (ICH) (10.4%). Mean (SD) Injury Severity Score was severe, 20.2 (8.2), and Glasgow Coma Score was moderate, 9.2 (12.8). The mortality rate was 16.7%. Retinal hemorrhages were not significantly associated with one type of neurotrauma over others. Ocular/adnexa contusion (OR 4.06; p < 0.001) and commotio retinae/Berlin\'s edema (OR 5.27; p < 0.001) had the greatest association with ICH than other neurotrauma. Optic neuropathy (OR 21.33; p < 0.001) and ICH (OR 3.34; p < 0.001) had the highest associated with mortality.
CONCLUSIONS: Our study supports previous studies showing that retinal and subdural hemorrhages were the most common ocular injury and neurotrauma in SBS, respectively. However, we did not find a significant propensity for their concurrence. Commotio retinae/Berlin\'s edema was significantly associated with both intracerebral and subdural hemorrhages.
摘要：
目标：摇床婴儿综合征（SBS），一部分虐待性头部创伤,非偶然的结果，剧烈的摇头。大多数幸存者遭受永久性神经后遗症。准确的诊断势在必行，仍然具有挑战性。这项研究的目的是描述可疑SBS的眼外伤和相关神经外伤。
方法：我们回顾性调查了2008-2014年国家创伤数据库中怀疑SBS入院年龄≤3岁的患者。采用SPSS软件进行统计学分析。显著性设定为p<0.05。
结果：2495例≤3岁的患者中有347例（13.9％）因怀疑SBS导致的虐待性头部创伤和眼部损伤而入院。大多数为<1岁（87.9％）和男性（54.2％）。常见的眼外伤为视网膜出血（30.5%），眼/附件挫伤（14.7%），视网膜水肿（10.7%）。常见的神经损伤为硬膜下（75.5%），蛛网膜下腔（23.9%），脑出血（ICH）（10.4%）。平均（SD）损伤严重程度评分为严重，20.2(8.2),格拉斯哥昏迷评分中等，9.2(12.8)。死亡率为16.7%。视网膜出血与一种类型的神经外伤没有显着相关。眼/附件挫伤（OR4.06；p<0.001）和视网膜/柏林水肿（OR5.27；p<0.001）与ICH的相关性最大。视神经病变（OR21.33;p<0.001）和ICH（OR3.34;p<0.001）与死亡率相关最高。
结论：我们的研究支持先前的研究，表明视网膜和硬膜下出血是SBS中最常见的眼外伤和神经损伤，分别。然而,我们没有发现他们同意的显著倾向。Commotio视网膜/柏林水肿与脑内和硬膜下出血均显着相关。
方法：我们回顾性调查了2008-2014年国家创伤数据库中怀疑SBS入院年龄≤3岁的患者。采用SPSS软件进行统计学分析。显著性设定为p<0.05。
结果：2495例≤3岁的患者中有347例（13.9％）因怀疑SBS导致的虐待性头部创伤和眼部损伤而入院。大多数为<1岁（87.9％）和男性（54.2％）。常见的眼外伤为视网膜出血（30.5%），眼/附件挫伤（14.7%），视网膜水肿（10.7%）。常见的神经损伤为硬膜下（75.5%），蛛网膜下腔（23.9%），脑出血（ICH）（10.4%）。平均（SD）损伤严重程度评分为严重，20.2(8.2),格拉斯哥昏迷评分中等，9.2(12.8)。死亡率为16.7%。视网膜出血与一种类型的神经外伤没有显着相关。眼/附件挫伤（OR4.06；p<0.001）和视网膜/柏林水肿（OR5.27；p<0.001）与ICH的相关性最大。视神经病变（OR21.33;p<0.001）和ICH（OR3.34;p<0.001）与死亡率相关最高。
结论：我们的研究支持先前的研究，表明视网膜和硬膜下出血是SBS中最常见的眼外伤和神经损伤，分别。然而,我们没有发现他们同意的显著倾向。Commotio视网膜/柏林水肿与脑内和硬膜下出血均显着相关。
