The positive predictive value of rib fractures as an indicator of nonaccidental trauma in children

Katherine A. Barsness*, Eun Suk Cha, Denis D. Bensard, Casey M. Calkins, David A. Partrick, Frederick M. Karrer, John D. Strain

*Corresponding author for this work

Research output: Contribution to journalArticle

152 Scopus citations

Abstract

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.

Original languageEnglish (US)
Pages (from-to)1107-1110
Number of pages4
JournalJournal of Trauma
Volume54
Issue number6
DOIs
StatePublished - Jun 2003

Keywords

  • Children
  • Nonaccidental trauma
  • Rib fractures

ASJC Scopus subject areas

  • Surgery
  • Critical Care and Intensive Care Medicine

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