Predictors of Neurologic Outcomes and Mortality in Physically Abused and Unintentionally Injured Children Admitted to Intensive Care Units

Background: This study aimed to identify the risk factors and predictors of neurologic outcomes and mortality for children with physical abuse and unintentional injury admitted to intensive care unit (ICU).Methods: We retrospectively evaluated the data for children with maltreatments admitted to the pediatric, neurosurgery and trauma ICUs between 2001 and 2019. Clinical factors were analyzed and compared between the physical abuse and the unintentional injury groups, including age, gender, season of admission, identifying settings, injury severity score, etiologies, length of ICU stay, neurologic outcomes, and mortality. Neurologic assessments were conducted with the Pediatric Cerebral Performance Category scale.Results: A total of 2,481 forensic children were collected, and there were 480 victims (19.3%) admitted to the ICus, including 156 physical abused and 324 unintentional injured. The significant difference between the two groups included age, histories of prematurity, clinical outcomes, head injury, neurosurgical interventions, clinical manifestations, brain computed tomography findings, and laboratory findings (all pConclusions: In children with physical abuse and unintentional injuries on ICU admission, initial presentation with shock and spontaneous hypothermia may serve as the powerful predictors for mortality; and shock and convulsion may serve as the powerful predictors for poor neurologic outcomes. In addition, retinal hemorrhage could be a risk factor for poor neurologic outcomes in critical victims with physical abuse, and spontaneous hypothermia could be a risk factor for poor neurologic outcomes in unintentional injuries.