Sentinel injuries are common in infants who are abused

(HealthDay)—Sentinel injuries are common among infants who suffer abuse and are rare in those who are evaluated for abuse and found to not be abused, according to a study published online March 11 in Pediatrics.

Lynn K. Sheets, M.D., from the Medical College of Wisconsin in Milwaukee, and colleagues conducted a retrospective study involving 401 infants (aged younger than 12 months) evaluated for abuse in a hospital-based setting. The frequency of sentinel injury (defined as a previous injury reported in the medical history that was suspicious for abuse) was compared in those infants who were evaluated and found to have definite concern for abuse, intermediate concern for abuse, or no abuse.

The researchers found that 27.5 percent of the 200 definitely abused infants had a previous sentinel injury, compared with 8 percent of 100 infants with intermediate concern for abuse (odds ratio, 4.4). None of the 101 infants without abuse (controls) had sentinel injury. In the definitely abused cohort, sentinel injury was most often bruising (80 percent), intraoral injury (11 percent), and other injury (7 percent). Sixty-six percent of sentinel injuries occurred before the age of 3 months, and 95 percent occurred at or before age 7 months. In 41.9 percent of the cases, medical providers were aware of the sentinel injury.

"Many definitely abused infants have a history of minor injuries that occurred before cruising, whereas such injuries are rare in infants evaluated for abuse and found to not be abused," the authors write. "Improved recognition of previous sentinel injuries combined with appropriate interventions would improve secondary prevention of abuse."

One author disclosed providing paid expert testimony for prosecution and defense attorneys in cases of alleged child physical maltreatment.

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