Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Comparative Study
. 2015 Sep;167(3):669-73.e1.
doi: 10.1016/j.jpeds.2015.05.042. Epub 2015 Jul 2.

Serum Cardiac Troponin I in the Evaluation of Nonaccidental Trauma

Berkeley L Bennett  1 , Paul Steele  2 , Cinnamon A Dixon  3 , E Melinda Mahabee-Gittens  4 , Jarrod Peebles  4 , Kimberly W Hart  5 , Christopher J Lindsell  5 , Michael S Chua  4 , Russel Hirsh  6
Affiliations
Comparative Study

Serum Cardiac Troponin I in the Evaluation of Nonaccidental Trauma

Berkeley L Bennett et al. J Pediatr. 2015 Sep.

Abstract

Objective: To determine if troponin I is more often elevated in children with suspected nonaccidental trauma (NAT) compared with uninjured children of similar age, and describe associations between troponin I elevation and NAT injuries.

Study design: Prospective 2-group study of children less than 2 years of age presenting to the emergency department with nonaccidental abdominal, thoracic, or intracranial injuries, and similarly aged uninjured children. Primary outcome was serum troponin I (≥ 0.04 ng/mL) using frozen blood samples from the 2 groups. Secondary outcomes included descriptive analyses of age, injury characteristics, and clinical appearance.

Results: There were 129 subjects; 60 injured patients and 69 uninjured patients. Groups had similar age and sex. Troponin I was elevated in 38% of injured children compared with 17% of uninjured children (P = .008). No uninjured patient over 3 months of age had elevated troponin I. Abdominal trauma, acute rib fractures, or the child's ill-appearance in the emergency department were associated with having elevated troponin I.

Conclusions: Troponin I is more often elevated in children with suspected NAT than uninjured children. Elevation of troponin I in children greater than 3 months of age with suspected NAT is concerning for trauma. Occult cardiac injury is more likely to occur in children with inflicted abdominal trauma, acute rib fractures, or ill appearance.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure
Figure
Empirical density plot with rug illustrating the significant difference in troponin I distribution for injured and uninjured patients. The small lines at the top and bottom of the graph show the location of each unique value. The curve shows how many patients are clustered at each location.
See this image and copyright information in PMC

References

    1. Jenny C, Isaac R. The relation between child death and child maltreatment. Arch Dis Child. 2006;91:265–9. - PMC - PubMed
    1. Roaten JB, Partrick DA, Nydam TL, Bensard DD, Hendrickson RJ, Sirotnak AP, et al. Nonaccidental trauma is a major cause of morbidity and mortality among patients at a regional level 1 pediatric trauma center. J Pediatr Surg. 2006;41:2013–5. - PubMed
    1. Krug EG, Mercy JA, Dahlberg LL, Zwi AB. World report on violence and health. Geneva: World Health Organization; 2002.
    1. Kellogg ND American Academy of Pediatrics CoCAaN. Evaluation of suspected child physical abuse. Pediatrics. 2007;119:1232–41. - PubMed
    1. Lindberg D, Makoroff K, Harper N, Laskey A, Bechtel K, Deye K, et al. Utility of hepatic transaminases to recognize abuse in children. Pediatrics. 2009;124:509–16. - PubMed

Publication types

LinkOut - more resources