Abstract | 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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Authors | Katherine J Deans, Jonathan Thackeray, Jonathan I Groner, Jennifer N Cooper, Peter C Minneci |
Journal | BMC pediatrics
(BMC Pediatr)
Vol. 14
Pg. 217
(Aug 31 2014)
ISSN: 1471-2431 [Electronic] England |
PMID | 25174531
(Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
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Topics |
- Child
- Child Abuse
(diagnosis, statistics & numerical data)
- Child, Preschool
- Cohort Studies
- Female
- Humans
- Infant
- Infant, Newborn
- Kaplan-Meier Estimate
- Male
- Medicaid
- Ohio
(epidemiology)
- Proportional Hazards Models
- Retrospective Studies
- Risk Factors
- United States
- Wounds and Injuries
(epidemiology, etiology)
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