Risk of Maltreatment-Related Injury: A Cross-Sectional Study of Children under Five Years Old Admitted to Hospital with a Head or Neck Injury or Fracture

Lee, Joseph; González-Izquierdo, Arturo; Gilbert, Ruth

doi:10.1371/journal.pone.0046522

Cited by 10 publications

(5 citation statements)

References 19 publications

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“…As in other research [ 26 ], we defined five measures of ACEs. The first relates to childhood victimisation, defined using a set of ICD-10 codes in any position of a finished consultant episode of an inpatient hospital admission [ 27 ]; we did not use P codes as these are neonatal related, for codes see Additional file 13, Table 11. Three further ACEs relate to household dysfunction and were defined as the presence of any of the following in an adult household member: (i) serious mental illness diagnosis (e.g.…”

Section: Methodsmentioning

confidence: 99%

Adverse childhood experiences and child mental health: an electronic birth cohort study

Lowthian

Anthony

Evans

et al. 2021

BMC Med

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Background Adverse childhood experiences (ACEs) are negatively associated with a range of child health outcomes. In this study, we explored associations between five individual ACEs and child mental health diagnoses or symptoms. ACEs included living with someone who had an alcohol-related problem, common mental health disorder or serious mental illness, or experienced victimisation or death of a household member. Methods We analysed data from a population-level electronic cohort of children in Wales, UK, (N = 191,035) between the years of 1998 and 2012. We used Cox regression with discrete time-varying exposure variables to model time to child mental health diagnosis during the first 15 years of life. Child mental health diagnoses include five categories: (i) externalising symptoms (anti-social behaviour), (ii) internalising symptoms (stress, anxiety, depression), (iii) developmental delay (e.g. learning disability), (iv) other (e.g. eating disorder, personality disorders), and (v) any mental health diagnosis, which was created by combining externalising symptoms, internalising symptoms and other. Our analyses were adjusted for social deprivation and perinatal risk factors. Results There were strong univariable associations between the five individual ACEs, sociodemographic and perinatal factors (e.g. gestational weight at birth) and an increased risk of child mental health diagnoses. After adjusting for sociodemographic and perinatal aspects, there was a remaining conditional increased risk of any child mental health diagnosis, associated with victimisation (conditional hazard ratio (cHR) 1.90, CI 95% 1.34–2.69), and living with an adult with a common mental health diagnosis (cHR 1.63, CI 95% 1.52–1.75). Coefficients of product terms between ACEs and deprivation were not statistically significant. Conclusion The increased risk of child mental health diagnosis associated with victimisation, or exposure to common mental health diagnoses, and alcohol problems in the household supports the need for policy measures and intervention strategies for children and their families.

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Section: Methodsmentioning

confidence: 99%

Adverse childhood experiences and child mental health: an electronic birth cohort study

Lowthian

Anthony

Evans

et al. 2021

BMC Med

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“… 13 Emergency hospital admissions are unpredictable, occur at short notice as a result of clinical need, and are common in children, primarily because of respiratory infections. 14 Emergency admissions because of childhood victimisation (maltreatment-related injuries, where there is concern about the welfare of the child), 15 injuries, and external causes (eg, accidents, self-harm, and assault) might be associated with inconsistent emotional or physical care, which might in turn be related to mental disorders or alcohol misuse in the household.…”

Section: Introductionmentioning

confidence: 99%

Risk of emergency hospital admission in children associated with mental disorders and alcohol misuse in the household: an electronic birth cohort study

Paranjothy

Evans

Bandyopadhyay

et al. 2018

The Lancet Public Health

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SummaryBackgroundMental disorders and alcohol misuse are common in families but their effects on the physical health of children are not known. We investigated the risk of emergency hospital admissions during childhood associated with living with an adult who has a mental health disorder, or who had an alcohol-related hospital admission.MethodsWe did this cohort study in a total population electronic child cohort in Wales, UK, which includes all children who live in Wales or with a mother who is resident in Wales. We used Cox regression to model time to first emergency hospital admission during the first 14 years of life associated with living with an adult who has a mental health disorder, or who had an alcohol-related hospital admission. We adjusted our results for social deprivation and perinatal risk factors.FindingsWe included data for 253 717 children with 1 015 614 child-years of follow-up. Living with an adult with a mental disorder was associated with an increased risk of emergency admission for all causes (adjusted hazard ratio [aHR] 1·17, 95% CI 1·16–1·19), for injuries and external causes (1·14, 1·11–1·18), and childhood victimisation (1·55, 1·44–1·67). Children living with a household member who had an alcohol-related hospital admission had a significantly higher risk of emergency admissions for injuries and external causes (aHR 1·13, 95% CI 1·01–1 ·26) and victimisation (1·39, 1·00–1·94), but not for all-cause emergency admissions (1·01, 0·93–1·09).InterpretationThe increased risk of emergency admissions in children associated with mental disorders and alcohol misuse in the household supports the need for policy measures to provide support to families that are affected.FundingEconomic and Social Research Council, Medical Research Council, Alcohol Research UK, Public Health Wales.

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“…Twenty-one studies simultaneously examined multiple types of maltreatment, with 18 focusing on physical abuse, neglect, and sexual abuse, and three also including emotional or psychological abuse (Guthridge et al, 2014; McKenzie et al, 2011; McKenzie & Scott, 2011). Among the included studies which focused on multiple maltreatment, the most common research objective (11 studies) was to determine the incidence or the trends of maltreatment-related injuries (Ben-Arieh & McDonell, 2009; Gonzalez-Izquierdo et al, 2010; Guthridge et al, 2014; Hunter & Bernstein, 2019; King et al, 2015; Lee et al, 2012; Lindberg et al, 2015; McDonell et al, 2015; Schilling et al, 2020; Somji et al, 2011; Wheeler et al, 2017). Four articles described the demographic and clinical characteristics of patients suspected for maltreatment (King et al, 2015; Kuang et al, 2018; Somji et al, 2011; Sonderman et al, 2018), two studies validated the ICD codes for maltreatment related injuries or circumstances (McKenzie et al, 2011; Raghavan et al, 2014), three focused on the process of identifying a set of ICD codes suggestive of maltreatment (Ben-Arieh & McDonell, 2009; McKenzie & Scott, 2011; Schnitzer et al, 2011), and three examined the relationships between maltreatment related injuries and child outcomes (e.g., child maltreatment fatalities; mental health, suicidal behavior, and out-of-home care; Dougall et al, 2020; Högberg et al, 2019; Kennedy et al, 2020).…”

Section: Resultsmentioning

confidence: 99%

Defining suspected child maltreatment using International Classification of Diseases codes: A scoping literature review

Liu

Terrell

Joyce

et al. 2022

Preprint

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Background: Administrative medical and claims records are increasingly used to study prevalence of and outcomes for children exposed to child maltreatment. However, suspicion of child maltreatment is often under-documented in medical records using International Classification of Diseases (ICD) codes. Although researchers have developed strategies to more broadly capture the injuries, illnesses, and circumstances that are suggestive of maltreatment, there is no consensus on which codes to use for this purpose. Objective: To systematically examine the types of research being conducted with ICD codes related to suspected maltreatment, summarize the methods used to identify the codes, and propose future direction. Methods: We searched five electronic databases for studies that reported ICD codes suggestive of child maltreatment in any medical setting, included participants aged 0-18 years, and published in a peer-reviewed journal in English. Two reviewers independently screened the titles, abstracts, and the full texts. Data were synthesized in a qualitative manner. Results: Thirty-seven studies met inclusion criteria. Most studies focused on determining the incidence or trends of maltreatment-related injuries or illnesses. Studies varied greatly in the codes used to identify suspected maltreatment. Only four articles reported on the validation of selected codes. ICD codes for transport accidents were the most frequently excluded co-occurring codes. Studies frequently relied on two seminal studies and two national-level guidelines. Conclusions: Substantial heterogeneity existed in the ICD codes and methods used to identify suspected maltreatment. The age range for codes, excluded co-occurring codes, and validation of codes are areas future research should address. This review may reduce costs for future researchers so that they could choose optimal measures of suspected maltreatment from our summarized list of codes without reinventing the wheel. Our review provides a basis for the development of recommended guidelines in establishing uniform codes for suspected maltreatment that could promote public health surveillance and allow for more efficient and uniform policy or program evaluation.

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Risk of Maltreatment-Related Injury: A Cross-Sectional Study of Children under Five Years Old Admitted to Hospital with a Head or Neck Injury or Fracture

Cited by 10 publications

References 19 publications

Adverse childhood experiences and child mental health: an electronic birth cohort study

Adverse childhood experiences and child mental health: an electronic birth cohort study

Risk of emergency hospital admission in children associated with mental disorders and alcohol misuse in the household: an electronic birth cohort study

Defining suspected child maltreatment using International Classification of Diseases codes: A scoping literature review

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