EY1920 Year Book

57 56 Background and Objectives § Abusive head trauma (AHT) is a severe childhood injury with high mortality and morbidity rates, often resulting in retinal haemorrhage (RH). § RH is present in many cases of AHT and since it is challenging to tell the difference between AHT and non- accidental injuries, presence of RH is proposed as a possible diagnostic marker to differentiate cases of abusive and accidental head trauma. § This study aims to determine whether AHT predicts RH better than accidental injury. Methods § All original studies published from 1990 to August 2018 were identified across 4 bibliographic databases, EMBASE, PubMed, CINAHL PLUS and Web of science. § Articles with subjects experiencing AHT or accidental injury before the age of 18 years, with outcomes specifically related to RH were included. § Random-effects meta-analysis was performed to generate summary effect sizes. Conclusion § AHT is found to predict RH better than accidental injury. § Healthcare practitioners should be mindful about the signs of RH which may suggest non-accidental injury causes Results § 44 studies were included § The pooled prevalence of RH amongst abused children was 62% (95% CI = 52% –70%). § The pooled prevalence of RH amongst injured children was 5% (95% CI = 2% –14%). § Further analyses found support for the positive association between RH and AHT (risk ratio (RR) = 16.92, 95% CI = 5.11 – 56.09). Prevalence of RH among abused children Prevalence of RH among injured children RETINAL HAEMORRHAGE AND ABUSIVE HEAD TRAUMA: A SYSTEMATIC REVIEWAND META-ANALYSIS Association of RH and child abuse MBBS Enrichment Year 2019/20 Chow Reena Full Year < RA - Retinal Haemorrhage and abusive head trauma: systematic review and meta-analysis at Department of Paediatrics and Adolescent Medicine, HKU, Hong Kong > Chow Reena Chow Yik Yee Eunice