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Risk of Maltreatment-Related Injury: A Cross-Sectional Study of Children under Five Years Old Admitted to Hospital with a Head or Neck Injury or Fracture

OBJECTIVES: To determine the predictive value and sensitivity of demographic features and injuries (indicators) for maltreatment-related codes in hospital discharge records of children admitted with a head or neck injury or fracture. METHODS: Study design: Population-based, cross sectional study. Se...

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Detalles Bibliográficos
Autores principales: Lee, Joseph Jonathan, Gonzalez-Izquierdo, Arturo, Gilbert, Ruth
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2012
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3485294/
https://www.ncbi.nlm.nih.gov/pubmed/23118853
http://dx.doi.org/10.1371/journal.pone.0046522
Descripción
Sumario:OBJECTIVES: To determine the predictive value and sensitivity of demographic features and injuries (indicators) for maltreatment-related codes in hospital discharge records of children admitted with a head or neck injury or fracture. METHODS: Study design: Population-based, cross sectional study. Setting: NHS hospitals in England. Subjects: Children under five years old admitted acutely to hospital with head or neck injury or fracture. Data source: Hospital Episodes Statistics, 1997 to 2009. Main outcome measure: Maltreatment-related injury admissions, defined by ICD10 codes, were used to calculate for each indicator (demographic feature and/or type of injury): i) the predictive value (proportion of injury admissions that were maltreatment-related); ii) sensitivity (proportion of all maltreatment-related injury admissions with the indicator). RESULTS: Of 260,294 childhood admissions for fracture or head or neck injury, 3.2% (8,337) were maltreatment-related. With increasing age of the child, the predictive value for maltreatment-related injury declined but sensitivity increased. Half of the maltreatment-related admissions occurred in children older than one year, and 63% occurred in children with head injuries without fractures or intracranial injury. CONCLUSIONS: Highly predictive injuries accounted for very few maltreatment-related admissions. Protocols that focus on high-risk injuries may miss the majority of maltreated children.