The Epidemiology of Nonaccidental Trauma in Children

Abstract

Background Abuse of children is abhorrent in Western society and, yet, is not uncommon. Nonaccidental trauma (NAT) is the result of a complex sociopathology. Not all of the causative factors of NAT are known, many are incompletely described, not all function in each case, and many are secondary to preexisting pathology in other areas. Questions/purposes We therefore addressed the following questions in this review: (1) Conclusions It is important to consider child, family, and societal factors when confronted with suspicions of child abuse. Our review demonstrates the currently limited information on the true incidence of NAT. To determine a much more accurate incidence of NAT, there needs to be a population-based surveillance program conducted through primary care providers.

Pediatric Nonaccidental Injury

“…5 As stated by Mulpuri and colleagues, there are limitations inherent in non-accidental injury research. The complexity of this sociopathology is reflected in the heterogeneity of the data published in the medical literature.…”

Infant Head Injury in Falls and Nonaccidental Trauma

“…Median ISS was markedly higher in the NAT group compared to those with falls. The GCS on presentation had a wide range in patients with NAT (3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15), whereas all patients with falls had GCS scores of 14 or 15 (Fig. 1).…”

“…4 In children who sustain injuries, it is important to differentiate accidental from nonaccidental mechanisms. [6][7][8][9] The mean age for victims of NAT has been reported between 0.5 and 11.8 months, and NAT carries the highest mortality of all traumatic mechanisms, most often related to head trauma. 5 Differentiation between injuries sustained during falls versus inflicted injuries remains a challenge especially in nonverbal children.…”

Evaluation of Child Maltreatment in the Emergency Department Setting

“…Studies are inconclusive on whether caregivers who were themselves abused are more likely to abuse others, although there seems to be a trend toward this being true. 15 Substance abuse and mental illness in abusers were also more common. 1 The Netherlands has recently instituted a protocol that screens adult ED patients with high-risk complaints for possible abuse of their children.…”