Pediatric hospitalizations due to serious abuse more frequent than expected
MedWire News: Research suggests that the rate of pediatric hospitalizations for serious abuse is high in the USA, particularly in children covered by Medicaid and in those less than 1 year of age.
John Leventhal (Yale University School of Medicine, New Haven, Connecticut, USA) and colleagues used data from the 2006 Kids' Inpatient Database to estimate the number of children under the age of 18 years who were hospitalized for serious abuse during 2006. This database includes information collected from 3739 hospitals in 38 states in 2006, representing 88.8% of the US population.
International Classification of Diseases codes were used to classify abuse, which included fractures, abdominal injuries, head injuries, burns, and wounds. The researchers note that this did not include children admitted to hospital for injuries suspicious for abuse, but that were eventually classified as nonabusive injuries.
Writing in Pediatrics, the researchers report that the total number of children hospitalized for abusive injuries was 4569, of whom 300 died of their injuries. This translates to an incidence of 6.2 hospitalizations per 100,000 children under the age of 18 years in 2006.
In terms of age, the incidence of hospitalization was highest in children under the age of 1 year, in whom the rate was 58.2 cases per 100,000 children.
"These numbers are higher than the rate of sudden infant death syndrome (about 50 per 100,000 births), which is alarming," said Leventhal, in a press statement.
The authors suggest: "Perhaps a national campaign to reduce serious abusive injuries would have similar success at decreasing abusive injuries in infants."
The highest incidence of hospitalizations overall was among children covered by Medicaid. These children had an incidence of hospitalization for abuse of 16.3 cases per 100,000 children under the age of 18 years and 133.1 per 100,000 children under the age of 1 year.
"This speaks to the importance of poverty as a risk factor for serious abuse," commented Leventhal.
The researchers say that their results are likely to be an underestimate of the overall incidence of serious abuse as they only looked at hospitalization rates, meaning that children who died before reaching hospital or who were not hospitalized were not counted.
The team estimated the total cost of the pediatric hospitalizations for abuse in 2006 to be US$ 73.8 million (€ 56.4 million).
"These data should be useful in examining trends over time and in studying the effects of large-scale prevention programs," remarked Leventhal.
By Helen Albert