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

dc.contributor.authorPuls, H. T., Anderst, J. D., Bettenhausen, J. L., Masonbrink, A., Markham, J. L., Plencner, L., ... & Hall, M.
dc.date.accessioned2019-04-02T17:33:39Z
dc.date.available2019-04-02T17:33:39Z
dc.date.issued2018
dc.description.abstractOBJECTIVES: 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.identifier.citationPuls, 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.urihttps://hosppeds.aappublications.org/content/hosppeds/early/2018/01/23/hpeds.2017-0109.full.pdf
dc.identifier.urihttp://hdl.handle.net/11212/4287
dc.language.isoenen_US
dc.publisherHospital pediatricsen_US
dc.subjectchild abuseen_US
dc.subjectabusive head traumaen_US
dc.subjectphysical abuseen_US
dc.subjectresearchen_US
dc.subjecthospitalen_US
dc.subjectstatisticsen_US
dc.subjectrevictimizationen_US
dc.titlePotential Opportunities for Prevention or Earlier Diagnosis of Child Physical Abuse in the Inpatient Settingen_US
dc.typeArticleen_US

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