XXXX in Canada: clinical characteristics and outcomes of hospital cases.

@entity1 @entity410 @entity227 @entity3702 @entity16 @entity542 @entity73 @entity2981 @entity130
BACKGROUND: @entity3702 is an extremely serious form of abusive @entity542 , the extent of which is unknown in Canada. Our objective was to describe, from a national perspective, the clinical characteristics and outcome of @entity1 admitted to hospital with @entity3702 . METHODS: We performed a retrospective chart review, for the years 1988-1998, of the cases of @entity3702 that were reported to the @entity1 protection teams of 11 pediatric tertiary care hospitals in Canada. @entity3702 was defined as any case reported at each institution of intracranial, intraocular or cervical @entity130 resulting from a substantiated or suspected shaking, with or without impact, in @entity1 aged less than 5 years. RESULTS: The median age of subjects was 4.6 months (range 7 days to 58 months), and 56% were @entity1 . Presenting complaints for the 364 @entity1 identified as having @entity3702 were nonspecific ( @entity410 -like episode [45%], decreased level of consciousness [43%] and respiratory difficulty [34%]), though @entity2981 was noted on examination in 46%. A history and/or clinical evidence of previous maltreatment was noted in 220 @entity1 (60%), and 80 families (22%) had had previous involvement with @entity1 welfare authorities. As a direct result of the shaking, 69 @entity1 died (19%) and, of those who survived, 162 (55%) had ongoing @entity16 and 192 (65%) had @entity227 . Only 65 (22%) of those who survived were considered to show no signs of @entity73 at the time of discharge. INTERPRETATION: @entity3702 results in an extremely high degree of mortality and morbidity. Ongoing care of these @entity1 places a substantial burden on the medical system, caregivers and society.
