TY - JOUR PY - 2024// TI - The shifting trends in the epidemiology and risk factors of non-accidental fractures in children JO - Child abuse and neglect A1 - Baghdadi, Soroush A1 - Momtaz, David A1 - Torres-Izquierdo, Beltran A1 - Pereira, Daniel E. A1 - Gonuguntla, Rishi A1 - Mittal, Mehul A1 - Hosseinzadeh, Pooya SP - e106692 EP - e106692 VL - 149 IS - N2 - BACKGROUND: Fractures are a common presentation of non-accidental trauma (NAT) in the pediatric population. However, the presentation could be subtle, and a high degree of suspicion is needed not to miss NAT.

OBJECTIVE: To analyze a comprehensive database, providing insights into the epidemiology of fractures associated with NAT. PARTICIPANTS AND SETTING: The TriNetX Research Network was utilized for this study, containing medical records from 55 healthcare organizations. TriNetX was queried for all visits in children under the age of 6 years from 2015 to 2022, resulting in a cohort of over 32 million.

METHODS: All accidental and non-accidental fractures were extracted and analyzed to determine the incidence, fracture location, and demographics of NAT. Statistical analysis was done on a combination of Python and Epipy.

RESULTS: Overall, 0.36 % of all pediatric patients had a diagnosis of NAT, and 4.93 % of fractures (34,038 out of 689,740 total fractures) were determined to be non-accidental. Skull and face fractures constituted 17.9 % of all NAT fractures, but rib/sternum fractures had an RR = 6.7 for NAT. Children with intellectual and developmental disability (IDD) or autism spectrum disorder (ASD) had a 9 times higher risk for non-accidental fractures. The number of non-accidental fractures significantly increased after 2019.

CONCLUSIONS: The study findings suggest that nearly 1 out of all 20 fractures in children under age 6 are caused by NAT, and that rib/sternum fractures are most predictive of an inflicted nature. The study also showed a significant increase in the incidence of NAT, during and after the pandemic.

Language: en

LA - en SN - 0145-2134 UR - http://dx.doi.org/10.1016/j.chiabu.2024.106692 ID - ref1 ER -