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.
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。