Risk factors for recurrent injuries in victims of suspected non-accidental trauma: a retrospective cohort study

Many children who are victims of non-accidental trauma (NAT) may be repeatedly evaluated for injuries related to maltreatment. The purpose of this study was to identify risk factors for repeated injuries in children with suspected NAT. We conducted a retrospective cohort study using claims data from...

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Bibliographic Details
Published in:BMC pediatrics 2014-08, Vol.14 (1), p.217-217, Article 217
Main Authors: Deans, Katherine J, Thackeray, Jonathan, Groner, Jonathan I, Cooper, Jennifer N, Minneci, Peter C
Format: Article
Language:English
Subjects:
Child
Child Abuse - diagnosis
Child Abuse - statistics & numerical data
Child, Preschool
Children
Children & youth
Cohort Studies
Female
Health aspects
Hospitals
Humans
Infant
Infant, Newborn
Kaplan-Meier Estimate
Male
Medicaid
Medical research
Medicine, Experimental
Mortality
Ohio - epidemiology
Proportional Hazards Models
Retrospective Studies
Risk Factors
Socioeconomic factors
Surveys
United States
Wounds and Injuries - epidemiology
Wounds and Injuries - etiology
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Summary:Many children who are victims of non-accidental trauma (NAT) may be repeatedly evaluated for injuries related to maltreatment. The purpose of this study was to identify risk factors for repeated injuries in children with suspected NAT. We conducted a retrospective cohort study using claims data from a pediatric Medicaid accountable care organization. Children with birth claims and at least one non-birth related claim indicating a diagnosis of NAT or skeletal survey in 2007-2011 were included. Recurrent events were defined as independent episodes of care involving an urgent/emergent care setting that included a diagnosis code specific for child abuse, a CPT code for a skeletal survey, or a diagnosis code for an injury suspicious for abuse. Cox proportional hazards models were used to examine risk factors for recurrent events. Of the 1,361 children with suspected NAT, a recurrent NAT event occurred in 26% within 1 year and 40% within 2 years of their initial event. Independent risk factors for a recurrent NAT event included a rural residence, age 
ISSN:1471-2431
1471-2431
DOI:10.1186/1471-2431-14-217