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Hospital Based Emergency Department Visits Attributed to Child Physical Abuse in United States: Predictors of In-Hospital Mortality

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  • Veerajalandhar Allareddy
  • Rahimullah Asad
  • Min Kyeong Lee
  • Romesh P Nalliah
  • Sankeerth Rampa
  • David G Speicher
  • Alexandre T Rotta
  • Veerasathpurush Allareddy

Abstract

Objectives: To describe nationally representative outcomes of physical abuse injuries in children necessitating Emergency Department (ED) visits in United States. The impact of various injuries on mortality is examined. We hypothesize that physical abuse resulting in intracranial injuries are associated with worse outcome. Materials and Methods: We performed a retrospective analysis of the Nationwide Emergency Department Sample (NEDS), the largest all payer hospital based ED database, for the years 2008–2010. All ED visits and subsequent hospitalizations with a diagnosis of “Child physical abuse” (Battered baby or child syndrome) due to various injuries were identified using ICD-9-CM (International Classification of Diseases, 9th Revision, Clinical Modification) codes. In addition, we also examined the prevalence of sexual abuse in this cohort. A multivariable logistic regression model was used to examine the association between mortality and types of injuries after adjusting for a multitude of patient and hospital level factors. Results: Of the 16897 ED visits that were attributed to child physical abuse, 5182 (30.7%) required hospitalization. Hospitalized children were younger than those released treated and released from the ED (1.9 years vs. 6.4 years). Male or female partner of the child’s parent/guardian accounted for >45% of perpetrators. Common injuries in hospitalized children include- any fractures (63.5%), intracranial injuries (32.3%) and crushing/internal injuries (9.1%). Death occurred in 246 patients (13 in ED and 233 following hospitalization). Amongst the 16897 ED visits, 1.3% also had sexual abuse. Multivariable analyses revealed each 1 year increase in age was associated with a lower odds of mortality (OR = 0.88, 95% CI = 0.81–0.96, p

Suggested Citation

  • Veerajalandhar Allareddy & Rahimullah Asad & Min Kyeong Lee & Romesh P Nalliah & Sankeerth Rampa & David G Speicher & Alexandre T Rotta & Veerasathpurush Allareddy, 2014. "Hospital Based Emergency Department Visits Attributed to Child Physical Abuse in United States: Predictors of In-Hospital Mortality," PLOS ONE, Public Library of Science, vol. 9(6), pages 1-8, June.
    • Handle: RePEc:plo:pone00:0100110
    DOI: 10.1371/journal.pone.0100110
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    1. Rosana E Norman & Munkhtsetseg Byambaa & Rumna De & Alexander Butchart & James Scott & Theo Vos, 2012. "The Long-Term Health Consequences of Child Physical Abuse, Emotional Abuse, and Neglect: A Systematic Review and Meta-Analysis," PLOS Medicine, Public Library of Science, vol. 9(11), pages 1-31, November.
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