title: Accuracy of the history of injury obtained from the caregiver in infantile head trauma.
abstract: OBJECTIVE
  We investigated the accuracy of parental reports of infant trauma history.
  
  
  METHODS
  We retrospectively reviewed 166 infants from 3 tertiary institutions in Japan that had suffered a traumatic intracranial hemorrhage between 2002 and 2013. The infants were classified into 3 groups based on the parents' report of the mechanism of injury: the low-risk group consisted of injuries sustained from falling off a height below 3 ft. (n=84); the middle-to-high-risk group comprised other mechanisms of injury (n=54); and the unknown-risk group consisted of unknown mechanisms of injury (n=28). The severity, neurological outcomes, clinical features, and evaluation for abuse were compared among these 3 groups.
  
  
  RESULTS
  Infants in the low-risk group had a higher severity, a worse neurological outcome, and a higher percentage of household injuries, retinal hemorrhage, subdural hematoma, and subdural hematoma suggestive of abusive head trauma (AHT) than those in the middle-to-high-risk group (P<.05). Infants in the unknown-risk group had the highest severity and the worst neurological outcomes, and a higher rate of features suggestive of AHT (P<.05).
  
  
  CONCLUSIONS
  The accuracy of the history obtained from the caregivers of infants may be low in severe infantile head trauma. Therefore, medical professionals should treat the mechanism of injury obtained from caregivers as secondary information and investigate for possible AHT in cases with inconsistencies between the history that was taken and the severity of the injury observed.
authors.affiliation: Department of Pediatric Intensive Care, Nagano Children's Hospital, 3100, Toyoshina, Azumino City, Nagano, 399-8288, Japan. Electronic address: amagasa0828@gmail.com.
authors.forename: Shunsuke
authors.initials: S
authors.lastname: Amagasa
authors.affiliation: Department of Pediatric Intensive Care, Nagano Children's Hospital, 3100, Toyoshina, Azumino City, Nagano, 399-8288, Japan.
authors.forename: Hikoro
authors.initials: H
authors.lastname: Matsui
authors.affiliation: Division of Emergency Service and Transport Medicine, National Center for Child Health and Development, 2-10-1, Okura, Setagaya-ku, Tokyo, 157-8535, Japan.
authors.forename: Satoshi
authors.initials: S
authors.lastname: Tsuji
authors.affiliation: Division of Emergency and Critical Care Medicine, Department of Acute Medicine, Nihon University School of Medicine, 30-1, Otaniguti, Kami-chou, Itabashi-ku, Tokyo, 173-8610, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Moriya
authors.affiliation: Division of Emergency and Critical Care Medicine, Department of Acute Medicine, Nihon University School of Medicine, 30-1, Otaniguti, Kami-chou, Itabashi-ku, Tokyo, 173-8610, Japan.
authors.forename: Kosaku
authors.initials: K
authors.lastname: Kinoshita
mesh_terms: D017028:Caregivers; D006259:Craniocerebral Trauma / Q000150:complications* / Q000175:diagnosis; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D020300:Intracranial Hemorrhages / Q000175:diagnosis / Q000209:etiology*; D008297:Male; D008487:Medical History Taking / Q000592:standards*; D011379:Prognosis; D015203:Reproducibility of Results; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D015599:Trauma Severity Indices