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Potential Opportunities for Prevention or Earlier Diagnosis of Child Physical Abuse in the Inpatient Setting

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dc.contributor.author Puls, H. T., Anderst, J. D., Bettenhausen, J. L., Masonbrink, A., Markham, J. L., Plencner, L., ... & Hall, M.
dc.date.accessioned 2019-04-02T17:33:39Z
dc.date.available 2019-04-02T17:33:39Z
dc.date.issued 2018
dc.identifier.citation Puls, H. T., Anderst, J. D., Bettenhausen, J. L., Masonbrink, A., Markham, J. L., Plencner, L., ... & Hall, M. (2018). Potential opportunities for prevention or earlier diagnosis of child physical abuse in the inpatient setting. Hospital pediatrics, hpeds-2017. en_US
dc.identifier.uri https://hosppeds.aappublications.org/content/hosppeds/early/2018/01/23/hpeds.2017-0109.full.pdf
dc.identifier.uri http://hdl.handle.net/11212/4287
dc.description.abstract OBJECTIVES: To compare rates of previous inpatient visits among children hospitalized with child physical abuse (CPA) with controls as well as between individual abuse types. METHODS: In this study, we used the Pediatric Health Information System administrative database of 44 children’s hospitals. Children ,6 years of age hospitalized with CPA between January 1, 2011, and September 30, 2015, were identified by discharge codes and propensity matched to accidental injury controls. Rates for previous visit types were calculated per 10 000 months of life. x2 and Poisson regression were used to compare proportions and rates. RESULTS: There were 5425 children hospitalized for CPA. Of abuse and accident cases, 13.1% and 13.2% had a previous inpatient visit, respectively. At previous visits, abused children had higher rates of fractures (rate ratio [RR] 5 3.0 times; P 5 .018), head injuries (RR 5 3.5 times; P 5 .005), symptoms concerning for occult abusive head trauma (AHT) (eg, isolated vomiting, seizures, brief resolved unexplained events) (RR 5 1.4 times; P 5 .054), and perinatal conditions (eg, prematurity) (RR 5 1.3 times; P 5 .014) compared with controls. Head injuries and symptoms concerning for occult AHT also more frequently preceded cases of AHT compared with other types of abuse (both P , .001). CONCLUSIONS: Infants hospitalized with perinatal-related conditions, symptoms concerning for occult AHT, and injuries are inpatient populations who may benefit from abuse prevention efforts and/or risk assessments. Head injuries and symptoms concerning for occult AHT (eg, isolated vomiting, seizures, and brief resolved unexplained events) may represent missed opportunities to diagnose AHT in the inpatient setting; however, this requires further study. en_US
dc.language.iso en en_US
dc.publisher Hospital pediatrics en_US
dc.subject child abuse en_US
dc.subject abusive head trauma en_US
dc.subject physical abuse en_US
dc.subject research en_US
dc.subject hospital en_US
dc.subject statistics en_US
dc.subject revictimization en_US
dc.title Potential Opportunities for Prevention or Earlier Diagnosis of Child Physical Abuse in the Inpatient Setting en_US
dc.type Article en_US


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