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Evaluation for Occult Fractures in Injured Children

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dc.contributor.author Wood, J. N., French, B., Song, L., & Feudtner, C.
dc.date.accessioned 2016-08-19T18:16:16Z
dc.date.available 2016-08-19T18:16:16Z
dc.date.issued 2015
dc.identifier.citation Wood, J. N., French, B., Song, L., & Feudtner, C. (2015). Evaluation for occult fractures in injured children. Pediatrics, 136(2), 232-240. en_US
dc.identifier.uri http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4516941/pdf/peds.2014-3977.pdf
dc.identifier.uri http://hdl.handle.net/11212/2908
dc.description.abstract Objectives: To examine variation across US hospitals in evaluation for occult fractures in (1) children <2 years old diagnosed with physical abuse and (2) infants <1 year old with injuries associated with a high likelihood of abuse and to identify factors associated with such variation. Methods: We performed a retrospective study in children <2 years old with a diagnosis of physical abuse and in infants <1 year old with non-motor vehicle crash–related traumatic brain injury or femur fractures discharged from 366 hospitals in the Premier database from 2009 to 2013. We examined across-hospital variation and identified child- and hospital-level factors associated with evaluation for occult fractures. Results: Evaluations for occult fractures were performed in 48% of the 2502 children with an abuse diagnosis, in 51% of the 1574 infants with traumatic brain injury, and in 53% of the 859 infants with femur fractures. Hospitals varied substantially with regard to their rates of evaluation for occult fractures in all 3 groups. Occult fracture evaluations were more likely to be performed at teaching hospitals than at nonteaching hospitals (all P < .001). The hospital-level annual volume of young, injured children was associated with the probability of occult fracture evaluation, such that hospitals treating more young, injured patients were more likely to evaluate for occult fractures (all P < .001). Conclusions: Substantial variation in evaluation for occult fractures among young children with a diagnosis of abuse or injuries associated with a high likelihood of abuse highlights opportunities for quality improvement in this vulnerable population. (Author Abstract) en_US
dc.language.iso en en_US
dc.publisher Pediatrics en_US
dc.subject child abuse en_US
dc.subject abusive head trauma en_US
dc.subject incidence en_US
dc.subject research en_US
dc.title Evaluation for Occult Fractures in Injured Children en_US
dc.type Article en_US


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