Recidivism following childhood maltreatment necessitating inpatient care in the United States
| Autor: | Faraz A. Khan, Anthony D. Sandler, Adil A. Shah, Wasay Nizam, Timothy D. Kane, Mikael Petrosyan |
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| Rok vydání: | 2022 |
| Předmět: |
Male
Child abuse medicine.medical_specialty Injury Severity Score Trauma Centers medicine Humans Child Abuse Child Psychiatry Retrospective Studies Inpatients Recidivism Inpatient care Abbreviated Injury Scale business.industry General Medicine Evidence-based medicine medicine.disease United States Case-Control Studies Wounds and Injuries Female Surgery Body region business Pediatric trauma |
| Zdroj: | The American Journal of Surgery. 223:774-779 |
| ISSN: | 0002-9610 2007-2015 |
| Popis: | Non-accidental trauma (NAT) is one of the common causes of injury in children in the United States (US). Abuse and maltreatment affect 2 per 100,000 children annually and may go unrecognized. The aim of this study to quantify the recidivistic nature of NAT in the US pediatric population.The National Readmissions Database (2007-2015) was queried for pediatric (≤18y) trauma patients. Children presenting for non-accidental trauma were further identified. Data was obtained on demographic, clinical, and hospital-level characteristics. Body regions with an Abbreviated Injury Scale (AIS) greater than three were further identified. Multivariable logistic regression analysis (adjusting for age, gender, insurance status, year, Injury Severity Score [ISS], hospital region, and mechanism of injury) was utilized to determine factors influencing unintentional and intentional (assault) non-accidental traumatic injuries.NAT represents 1.6% (n = 4,634/286,508) of all pediatric trauma. The median age of presentation was1y [IQR:0-3] with a male predominance (56.2%). Median ISS was 9 [IQR:2-16]. 87.5% of incidents represented assault (intentional). The most commonly affected body region was the head and neck (32.8%), followed by the extremities (11.4%) and soft tissue trauma or burns (6.3%). Penetrating trauma accounted for 18% of these injuries. 3.2% were readmitted to the hospital for a recurrent episode. 85.5% presented to the hospital for their initial evaluation. Mortality rates were 3.8% for those re-admitted to the hospital. The most common perpetrators were other specified persons known to the family, followed by fathers and mothers.Although uncommon, recidivism, after an initial episode of NAT, can have devastating consequences. The majority of the perpetrators of abuse are individuals known to the patient or family. Health policy aimed towards developing preventative strategies is needed to facilitate early recognition and tackle abuse in children.III.Case Control Study. |
| Databáze: | OpenAIRE |
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