Identifying Populations at Risk for Child Abuse: A Nationwide Analysis

J Pediatr Surg. 2020 Jan;55(1):135-139. doi: 10.1016/j.jpedsurg.2019.09.069. Epub 2019 Oct 24.

Abstract

Purpose: 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. χ2 analysis was used; significance equals p < 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 < 0. 001) and emotional abuse (75% vs. 60%, p < 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 < 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.

Keywords: Abuse; Psychiatric diagnosis; Traumatic injuries.

MeSH terms

  • Adolescent
  • Child
  • Child Abuse / diagnosis
  • Child Abuse / statistics & numerical data*
  • Child Abuse, Sexual / statistics & numerical data
  • Child, Preschool
  • Chronic Disease / epidemiology
  • Databases, Factual
  • Female
  • Humans
  • Infant
  • Male
  • Mental Disorders / epidemiology*
  • Patient Readmission / statistics & numerical data*
  • Retrospective Studies
  • Risk Factors
  • United States / epidemiology
  • Wounds and Injuries / epidemiology*