The positive predictive value of rib fractures as an indicator of nonaccidental trauma in children. J Trauma 2003 Jun;54(6):1107-10
Date
06/19/2003Pubmed ID
12813330DOI
10.1097/01.TA.0000068992.01030.A8Scopus ID
2-s2.0-0038801370 (requires institutional sign-in at Scopus site) 185 CitationsAbstract
BACKGROUND: Rib fractures have a strong association with nonaccidental trauma (NAT) and severe trauma. The purposes of this study were to evaluate rib fractures in children to determine (1) the positive predictive value of a rib fracture in defining NAT and (2) the frequency of rib fractures as the only skeletal manifestation of NAT.
METHODS: We reviewed the medical records and imaging of all children with rib fractures over a 6-year period. NAT was determined by the Child Advocacy and Protection team.
RESULTS: In children younger than 3 years of age, the positive predictive value (PPV) of a rib fracture as an indicator of NAT was 95%. The positive predictive value increased to 100% once historical and clinical circumstance excluded all other causes for rib fractures.
CONCLUSION: In this study, rib fracture(s) were the only skeletal manifestation of NAT in 29% of the children.
Author List
Barsness KA, Cha ES, Bensard DD, Calkins CM, Partrick DA, Karrer FM, Strain JDAuthor
Casey Matthew Calkins MD Professor in the Surgery department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
AdolescentAge Distribution
Child
Child Abuse
Child, Preschool
Colorado
Comorbidity
Female
Humans
Infant
Infant, Newborn
Male
Predictive Value of Tests
Radiography
Retrospective Studies
Rib Fractures
Trauma Centers
Wounds, Nonpenetrating
