BACKGROUND: Victims of abusive @entity542 have poor outcomes compared to other injured @entity1 . There is often a delay in diagnosis as these young @entity1 are unable to communicate with healthcare providers. These critically injured @entity1 would benefit from early identification and therapy. METHODS: We performed a retrospective review of our single hospital @entity130 registry from 2005-2014. All level 1 pediatric (age 0-17) @entity130 @entity1 who sustained abusive @entity542 were included. Exclusion criteria included: no admission coagulation studies, prehospital product transfusion, preexisting @entity3459 or @entity204 upon arrival. Primary outcome was mortality; secondary outcomes were early blood transfusion and neurosurgical intervention.Univariate analysis included Fisher exact and Wilcoxon rank-sum testing; we then performed logistic regression modeling and calculated adjusted odds ratios (AOR) to control for known predictors of poor outcome including @entity551 , @entity2332 , @entity520 , @entity2992 , and Head AIS. RESULTS: In 101 total subjects, 35% (n=35) had INR>= 1.3 on admission. On univariate analysis, @entity1 with @entity3459 were more likely to have @entity2332 , @entity551 , @entity520 , high @entity2992 and low GCS (all p<0.05). There was no difference in age, @entity417 , and incidence of @entity1230 . Overall mortality was 24.8% (n=25) which varied significantly based on admission INR (60% INR>= 1.3 vs 6% INR>1.3, p<0.001). @entity1 with elevated INR were also more likely to have early PRBC transfusion (p=0.003) and neurosurgical intervention (p=0.011). In logistic regression analysis, admission INR was the strongest independent predictor of mortality with increased odds of 3.65 (p=0.045). Adjusted odds ratio after controlling specifically for @entity551 , @entity2332 and @entity520 was 6.25 (p=0.006) and after controlling for head AIS and admission GCS the AOR=5.27 (p=0.007). CONCLUSIONS: Admission INR>= 1.3 strongly predicts mortality in abusive @entity542 . These @entity1 should be targeted for early aggressive interventions and monitoring with the goal of improving @entity1 outcomes. Further study is warranted to investigate potential therapeutic targets in @entity130 -induced @entity3459 . LEVEL OF EVIDENCE: III, prognostic and epidemiological.

Elevated admission INR strongly predicts mortality in victims of abusive XXXX .

@entity1 :: ('9606', 'Species') :: ['children', 'Patients', 'patients', 'patient'] @entity2332 :: ('MESH:D007035', 'Disease') :: ['hypothermia'] @entity417 :: ('MESH:D000740', 'Disease') :: ['anemia'] @entity542 :: ('MESH:D006259', 'Disease') :: ['head trauma'] @entity3459 :: ('MESH:D025861', 'Disease') :: ['coagulation disorder', 'coagulation dysregulation'] @entity551 :: ('MESH:D007022', 'Disease') :: ['hypotension'] @entity520 :: ('MESH:D000138', 'Disease') :: ['acidosis'] @entity2992 :: ('MESH:C564479', 'Disease') :: ['ISS'] @entity1230 :: ('MESH:D009104', 'Disease') :: ['polytrauma'] @entity204 :: ('MESH:D003643', 'Disease') :: ['death'] @entity130 :: ('MESH:D014947', 'Disease') :: ['trauma']
@entity542 :: (MESH:D006259,Disease) :: ['head trauma']
