ArticlePloS one2014
Hospital based emergency department visits attributed to child physical abuse in United States: predictors of in-hospital mortality.
Article in PloS one, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
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Who cites it
9 citing papers in PubMed, 36 citations in OpenAlex.
- Association Between Adolescent Violence Exposure and the Risk of Suicide: A 15-Year Study in Taiwan.Children (Basel, Switzerland) · 2024Article
- A Scoping Review of Current Social Emergency Medicine Research.The western journal of emergency medicine · 2021Article
- Domestic violence and abuse related emergency room visits in Ontario, Canada.BMC public health · 2021Article
- Intracranial Injury Among Children with Abuse-Related Long Bone Fractures.The Journal of emergency medicine · 2020Article
- Risk Factors for Child Maltreatment Fatalities in a National Pediatric Inpatient Database.Hospital pediatrics · 2020Article
- Association between emergency department utilization and the risk of child maltreatment in young children.Injury epidemiology · 2018Article
- Relationship between Insurance Type and Discharge Disposition From the Emergency Department of Young Children Diagnosed with Physical Abuse.The Journal of pediatrics · 2016Article
- Individual, family, and culture level contributions to child physical abuse and neglect: A longitudinal study in nine countries.Development and psychopathology · 2015Article
- Dentist attitudes and responsibilities concerning child sexual abuse. A review and a case report.Journal of clinical and experimental dentistry · 2015Review
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Authors and funding
8 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesTo describe nationally representative outcomes of physical abuse injuries in children necessitating Emergency Department (ED) visits in United States. The impact of various injuries on mortality is examined. We hypothesize that physical abuse resulting in intracranial injuries are associated with worse outcome. MATERIALS AND
methodsWe performed a retrospective analysis of the Nationwide Emergency Department Sample (NEDS), the largest all payer hospital based ED database, for the years 2008-2010. All ED visits and subsequent hospitalizations with a diagnosis of "Child physical abuse" (Battered baby or child syndrome) due to various injuries were identified using ICD-9-CM (International Classification of Diseases, 9th Revision, Clinical Modification) codes. In addition, we also examined the prevalence of sexual abuse in this cohort. A multivariable logistic regression model was used to examine the association between mortality and types of injuries after adjusting for a multitude of patient and hospital level factors.
resultsOf the 16897 ED visits that were attributed to child physical abuse, 5182 (30.7%) required hospitalization. Hospitalized children were younger than those released treated and released from the ED (1.9 years vs. 6.4 years). Male or female partner of the child's parent/guardian accounted for >45% of perpetrators. Common injuries in hospitalized children include- any fractures (63.5%), intracranial injuries (32.3%) and crushing/internal injuries (9.1%). Death occurred in 246 patients (13 in ED and 233 following hospitalization). Amongst the 16897 ED visits, 1.3% also had sexual abuse. Multivariable analyses revealed each 1 year increase in age was associated with a lower odds of mortality (OR = 0.88, 95% CI = 0.81-0.96, p < 0.0001). Females (OR = 2.39, 1.07-5.34, p = 0.03), those with intracranial injuries (OR = 65.24, 27.57-154.41, p<0.0001), or crushing/internal injury (OR = 4.98, 2.24-11.07, p<0.0001) had higher odds of mortality compared to their male counterparts.
conclusionsIn this large cohort of physically abused children, younger age, females and intracranial or crushing/internal injuries were independent predictors of mortality. Identification of high risk cohorts in the ED may enable strengthening of existing screening programs and optimization of outcomes.
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