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Master Thesis

Traumatismes crâniens non accidentels de l'enfant de moins de 5 ans : description des cas, détermination des critères liés à la probabilité diagnostique, et comparaison du parcours de soins aux urgences par rapport aux enfants de moins de 5 ans hospitalisés pour fièvre

Abstract : Objectives: our study aimed to describe the children younger than six years old victim of Abusive Head Trauma (AHT), to determine factors influencing the diagnostic probability and to compare the children’s characteristics, their care pathways through emergencies before the diagnosis was made, with children hospitalized for fever. Methods: a retrospective monocentric case control study was realized at the Children’s Hospital of the University Hospital of Bordeaux, between October 2010 and April 2018. Cases were children younger than six years old hospitalized for AHT. Controls were children matched on age, immunocompetent, hospitalized for fever. Different variables were gathered in the medical data file for cases and controls. Univariate analyses were performed to compare probable and possible cases, and to compare cases and control characteristics. Univariate and multivariate analyses were performed to compare the fact of having at least once emergency department visit in our hospital. Results: 75 cases and 75 controls were included. No case had previously visited emergency department for crying. Compared to probable cases, possible cases had less SDH (29% vs 94% ; p<0.0001), and less bone radiological assessments were performed (61% vs 87% ; p=0.0319). Compared to controls, cases were mostly males (OR=0,265 ; p=0.0051), and had visited less often the emergency department(OR=30,214 ; p<0.0001). Conclusion: the likelihood of AHT was associated with the seriousness of the consequences on the child’s health. Compared to controls, cases were mostly males and visited less often our emergency department.
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Submitted on : Thursday, June 11, 2020 - 11:23:49 AM
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Ambre Lafagne. Traumatismes crâniens non accidentels de l'enfant de moins de 5 ans : description des cas, détermination des critères liés à la probabilité diagnostique, et comparaison du parcours de soins aux urgences par rapport aux enfants de moins de 5 ans hospitalisés pour fièvre. Sciences du Vivant [q-bio]. 2020. ⟨dumas-02864679⟩

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