Publication Detail

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Outcomes for children hospitalized with abusive versus noninflicted abdominal trauma.

Wendy Gwirtzman Lane; Irwin Lotwin; Howard Dubowitz; Patricia Langenberg; Patricia Dischinger (Profiled Authors: Patricia C Dischinger; Howard Dubowitz; Wendy G Lane)

Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, MD 21201, USA. wlane@epi.umaryland.edu
Pediatrics 2011;127(6):e1400-5.

BACKGROUND: Abusive abdominal trauma (AAT) is the second leading cause of child abuse mortality. Previous outcome studies have been limited to data from trauma centers. OBJECTIVES: The goals of this study were (1) to examine mortality, length of hospitalization, and hospital charges among a national sample of children hospitalized for AAT; and (2) to compare these outcomes with children with noninflicted abdominal trauma. METHODS: Hospitalization data for children aged 0 to 9 years were obtained from the 2003 and 2006 Kids' Inpatient Database. Cases were identified using International Classification of Diseases, Ninth Revision, Clinical Modification and external cause of injury codes. Multivariable regression analyses were used to compare outcomes of children with AAT versus those with noninflicted injury. RESULTS: Children with AAT were younger, and more often insured by Medicaid. Among children surviving to discharge, those with AAT had longer hospitalizations (adjusted mean [95% confidence interval (CI)] length of stay: 7.9 (6.6-9.3) vs 6.4 (6.1-6.7) days, P < .01) and higher charges (adjusted mean [95% CI] costs: $24 343 [$20 952-$28 567] vs $19 341 [$18 770-$20 131]; P < .01). Among children aged 1 to 9 years, those with AAT had higher mortality (adjusted rate [95% CI]: 9.2% [5.0%-16.1%] vs 2.7% [2.2%-3.2%], P < .01). There was no significant difference in mortality for children aged younger than 1 year. CONCLUSIONS: Children hospitalized for AAT generally had poorer short-term outcomes compared with children with noninflicted abdominal trauma. Studies to explain these differences are needed. In addition, efforts to prevent these injuries and to assist families at risk should be supported.

1 Originating Grant

• 1.

  LANE, WENDY GWIRTZMAN

  Epidemiology and Prevention of Abusive Abdominal Trauma in Children

  12 March 2008 - 28 February 2013

  EUNICE KENNEDY SHRIVER NATIONAL INSTITUTE OF CHILD HEALTH &HUMAN DEVELOPMENT

Scientific Context

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