title: Early clinical indicators of developmental outcome in abusive head trauma.
abstract: OBJECTIVE
  The purpose of the study was to determine the developmental prognostic significance of early clinical indicators in abusive head trauma.
  
  
  METHODS
  Seventy-one children were diagnosed with abusive head trauma and followed in a post-injury growth and development clinic. A retrospective chart review was completed to gather clinical features at the time of injury, including presence or absence of early post-traumatic seizures, presence or absence of intubation, and presence or absence of pediatric intensive care unit admission. Children then underwent developmental testing with use of the Capute Scales of the Cognitive Adaptive Test (CAT) and the Clinical Linguistic and Auditory Milestone Scale (CLAMS) during follow-up clinic visits. Clinical features at initial injury were compared to developmental outcome.
  
  
  RESULTS
  Thirty-four of 71 patients with seizures during their admission hospitalization scored significantly lower on follow-up developmental testing than patients who did not have seizures. Twenty-one of 71 patients who required intubation scored lower on developmental testing than patients who did not require intubation. Thirty-five of 71 patients who required pediatric intensive care unit admission scored lower on developmental testing than patients who did not require pediatric intensive care unit admission.
  
  
  CONCLUSIONS
  This study demonstrates that clinical factors at the time of injury, such as early post-traumatic seizures and intubation requirement, are associated with poorer developmental outcome. This study also suggests that close developmental follow-up should be obtained for all children with abusive head trauma, regardless of whether or not the child was admitted to the PICU.
authors.affiliation: Department of Pediatrics, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, Cincinnati, OH 45229, USA. mary.greiner@cchmc.org
authors.forename: Mary V
authors.initials: MV
authors.lastname: Greiner
authors.forename: Alice P
authors.initials: AP
authors.lastname: Lawrence
authors.forename: Paul
authors.initials: P
authors.lastname: Horn
authors.forename: Amy J
authors.initials: AJ
authors.lastname: Newmeyer
authors.forename: Kathi L
authors.initials: KL
authors.lastname: Makoroff
mesh_terms: D001930:Brain Injuries / Q000150:complications*; D002648:Child; D002649:Child Abuse; D002675:Child, Preschool; D006259:Craniocerebral Trauma / Q000150:complications*; D002658:Developmental Disabilities / Q000175:diagnosis* / Q000209:etiology*; D006760:Hospitalization; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D015278:Intensive Care Units, Pediatric; D007440:Intubation; D009483:Neuropsychological Tests; D011379:Prognosis; D012189:Retrospective Studies; D012640:Seizures / Q000209:etiology