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

BACKGROUND: 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. METHODS: We conducted a retrospective cohort study u...

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Autores principales: Deans, Katherine J, Thackeray, Jonathan, Groner, Jonathan I, Cooper, Jennifer N, Minneci, Peter C
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2014
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4236666/
https://www.ncbi.nlm.nih.gov/pubmed/25174531
http://dx.doi.org/10.1186/1471-2431-14-217
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author Deans, Katherine J
Thackeray, Jonathan
Groner, Jonathan I
Cooper, Jennifer N
Minneci, Peter C
author_facet Deans, Katherine J
Thackeray, Jonathan
Groner, Jonathan I
Cooper, Jennifer N
Minneci, Peter C
author_sort Deans, Katherine J
collection PubMed
description BACKGROUND: 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. METHODS: 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. RESULTS: 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 < 30 months old, having only 1 or 2 initially detected injuries, and having a dislocation, open wound, or superficial injury at the previous event (p ≤ 0.01 for all). CONCLUSIONS: Over 25% of children who experienced a suspected NAT event had a recurrent episode within one year. These children were younger and more likely to present with “minor” injuries at their previous event.
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spelling pubmed-42366662014-11-20 Risk factors for recurrent injuries in victims of suspected non-accidental trauma: a retrospective cohort study Deans, Katherine J Thackeray, Jonathan Groner, Jonathan I Cooper, Jennifer N Minneci, Peter C BMC Pediatr Research Article BACKGROUND: 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. METHODS: 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. RESULTS: 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 < 30 months old, having only 1 or 2 initially detected injuries, and having a dislocation, open wound, or superficial injury at the previous event (p ≤ 0.01 for all). CONCLUSIONS: Over 25% of children who experienced a suspected NAT event had a recurrent episode within one year. These children were younger and more likely to present with “minor” injuries at their previous event. BioMed Central 2014-08-31 /pmc/articles/PMC4236666/ /pubmed/25174531 http://dx.doi.org/10.1186/1471-2431-14-217 Text en Copyright © 2014 Deans et al.; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/4.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research Article
Deans, Katherine J
Thackeray, Jonathan
Groner, Jonathan I
Cooper, Jennifer N
Minneci, Peter C
Risk factors for recurrent injuries in victims of suspected non-accidental trauma: a retrospective cohort study
title Risk factors for recurrent injuries in victims of suspected non-accidental trauma: a retrospective cohort study
title_full Risk factors for recurrent injuries in victims of suspected non-accidental trauma: a retrospective cohort study
title_fullStr Risk factors for recurrent injuries in victims of suspected non-accidental trauma: a retrospective cohort study
title_full_unstemmed Risk factors for recurrent injuries in victims of suspected non-accidental trauma: a retrospective cohort study
title_short Risk factors for recurrent injuries in victims of suspected non-accidental trauma: a retrospective cohort study
title_sort risk factors for recurrent injuries in victims of suspected non-accidental trauma: a retrospective cohort study
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4236666/
https://www.ncbi.nlm.nih.gov/pubmed/25174531
http://dx.doi.org/10.1186/1471-2431-14-217
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