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Bruising Pattern Can Predict Likelihood of Child Abuse

Bruising based on body region and age used to develop clinical decision rule predicting abuse

TUESDAY, Dec. 8 (HealthDay News) -- Bruising characteristics based on age can be used to predict whether a child's injuries are likely to be due to physical abuse or an accident, according to a study published online Dec. 7 in Pediatrics.

Mary Clyde Pierce, M.D., from the University of Louisville in Kentucky, and colleagues examined the bruising characteristics of 95 children up to 4 years of age who were admitted to the pediatric intensive care unit for trauma, of which 42 were victims of physical abuse and 53 were victims of accidental trauma.

The researchers found that 71 children (33 in the abuse group and 38 in the accident group) had bruising. Bruising on the torso, ear or neck was predictive of abuse in children 4 years of age or younger, while bruising in any region was predictive of abuse in infants younger than 4 months. These bruising characteristics, plus the presence of a confirmed accident in a public setting that could account for the bruising, were used to develop a clinical decision rule that had a sensitivity of 97 percent and a specificity of 84 percent for predicting abuse.

"Discriminating differences exist in bruising characteristics for abusive versus accidental trauma," Pierce and colleagues conclude. "The body region- and age-based bruising clinical decision rule model functions as a clinically sensible screening tool to identify young children who require further evaluation for abuse."

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