title: Frequency of suspected abuse/neglect in burn patients.
abstract: This study was conducted to determine the frequency of suspected abuse/neglect in pediatric patients with burns presenting to an emergency department. Criteria were established for the suspicion of abuse/neglect. During a 12-month period, 431 patients were evaluated. Eighty-four (19.5%) were suspected of being abused or neglected. The frequency of suspected abuse/neglect in single-parent families was 22%, compared to 10% for married couples (P = 0.027). There was no significant difference in the rate of suspected abuse/neglect in patients seen fewer than or more than 24 hours after the injury occurred. Seventy-five children (17%) had more than two burn sites, with 24 (32%) appearing to be a result of abuse/neglect (P = 0.01). One hundred twenty-eight patients (30%) were admitted to the hospital, with 34% suspected of being abused/neglected, compared to 13% who were treated on an ambulatory basis (P = 0.00005). Fifty-eight (69%) of the suspected abused/neglected patients were diagnosed based on the history and/or physical examination. The medical records of 31% revealed previous abuse/neglect, ingestion, failure to thrive, or old burns. We conclude that abuse or neglect is a significant factor in pediatric burn patients and that the child's previous medical record must be reviewed. Other associated factors include a single parent family or the child with greater than two burn sites. The actual incidence of abuse/neglect could not be determined, owing to laws regarding confidentiality.
authors.affiliation: Department of Pediatrics, Wayne State University School of Medicine, Detroit, MI.
authors.forename: N M
authors.initials: NM
authors.lastname: Rosenberg
authors.forename: D
authors.initials: D
authors.lastname: Marino
mesh_terms: D002056:Burns; D002649:Child Abuse / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology*; D002675:Child, Preschool; D003219:Confidentiality; D004630:Emergencies; D005260:Female; D006760:Hospitalization; D006801:Humans; D015994:Incidence; D007223:Infant; D008297:Male; D008499:Medical Records; D008824:Michigan / Q000453:epidemiology; D012189:Retrospective Studies; D015406:Single Parent; D013997:Time Factors; D014505:Urban Population