SAFETYLIT WEEKLY UPDATE

We compile citations and summaries of about 400 new articles every week.
RSS Feed

HELP: Tutorials | FAQ
CONTACT US: Contact info

Search Results

Journal Article

Citation

Puls HT, Anderst JD, Bettenhausen JL, Masonbrink A, Markham JL, Plencner L, Krager M, Johnson MB, Walker JM, Greeley CS, Hall M. Hosp. Pediatr. 2018; ePub(ePub): ePub.

Affiliation

Children's Hospital Association, Lenexa, Kansas.

Copyright

(Copyright © 2018, American Academy of Pediatrics Section on Hospital Medicine)

DOI

10.1542/hpeds.2017-0109

PMID

29371238

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. χ2 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] = 3.0 times; P =.018), head injuries (RR = 3.5 times; P =.005), symptoms concerning for occult abusive head trauma (AHT) (eg, isolated vomiting, seizures, brief resolved unexplained events) (RR = 1.4 times; P =.054), and perinatal conditions (eg, prematurity) (RR = 1.3 times; P =.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.

Copyright © 2018 by the American Academy of Pediatrics.


Language: en

NEW SEARCH


All SafetyLit records are available for automatic download to Zotero & Mendeley
Print