Identifying Populations at Risk for Child Abuse: A Nationwide Analysis

Abstract

a b s t r a c tPurpose: Child abuse is a national, often hidden, epidemic. The study objective was to determine at-risk populations that have been previously hospitalized prior to their admission for child abuse. Methods: The Nationwide Readmissions Database (NRD) was queried for all children hospitalized for abuse. Outcomes were previous admissions and diagnoses. χ 2 analysis was used; significance equals p b 0.05. Results: 31,153 children were hospitalized for abuse (half owing to physical abuse) during the study period. 11% (n = 3487) of these children had previous admissions (one in three to a different hospital), while 3% (n = 1069) had multiple hospitalizations. 60% of prior admissions had chronic conditions, and 12% had traumatic injuries. Children with chronic conditions were more likely to have sexual abuse (89% vs. 57%, p b 0. 001) and emotional abuse (75% vs. 60%, p b 0. 01). 25% of chronic diagnoses were psychiatric, who were also more likely to have sexual and emotional abuse (47% vs. 5.5% and 10% vs. 1%, all p b 0. 001). Conclusion: This study uncovers a hidden population of children with past admissions for chronic conditions, especially psychiatric diagnoses that are significantly associated with certain types of abuse. Improved measures to accurately identify at-risk children must be developed to prevent future childhood abuse and trauma. Level of evidence: Level III. Type of study: Retrospective comparative study.

The Effect of COVID on Child Maltreatment: A Review

“…This aligns from data collected by the Centers for Disease Control (CDC, 2020b) which found a significant increase in child abuse cases across many U.S. emergency department visits throughout early 2020. And while these cases were not classified by maltreatment type, physical abuse is the most prominent form of harm inflicted onto young children which results in hospitalization [103,161,197].…”

The Roadmap for Resilience: The California Surgeon General's Report on Adverse Childhood Experiences, Toxic Stress, and Health

“…1173 Young children are the most likely to experience substantiated abuse and/ or neglect. 1174 In California, nearly half (45%) of children who have experienced substantiated child abuse or neglect were five years of age or younger, and most of these (62%) were two years or younger. 1172 Between 70% and 80% of the 148 children officially determined to have died due to abuse in California in 2018 were under five.…”

Differential Diagnosis between Child Abuse and Infantile Cortical Hyperostosis: A Case Report and Literature Review

“…Case histories can be provided incorrectly or not be provided intentionally by caretakers, which may mislead the clinician to miss the diagnosis of child maltreatment. Cutaneous injury, known as the most common injury of abuse, can sometimes fade, despite the presence of significant skeletal injury [2]. Although early identification of abuse is difficult, it is important to detect cases of minor injury to protect the child and family from future harm.…”