Child abuse. An update on surgical management in 256 cases.
In the period January 1982-July 1984, 1512 cases of suspected child abuse were evaluated in the emergency department of a major children's hospital, of which 256 (17%) required hospitalization. Failure-to-thrive with caloric malnutrition was present in 66 (26%), burns in 56 (22%), central nervous system injury in 53 (22%), soft tissue trauma in 21 (8%), ingestions in 20 (8%), skeletal injury in 15 (6%), neglect of an underlying disease in 10 (4%), sexual abuse in nine (3%), near-drowning in four (1%), and abdominal trauma in two (1%). Two-thirds of the children required surgical care and one-third of the surgical group needed operations. The majority of the patients were toddlers between 18 and 36 months of age. A long hospitalization occurred with a mean stay of 9.3 days. Mortality was 7% for the entire group, but children with central nervous system injury had a much higher mortality (26%) and morbidity (21%).
D000293:Adolescent; D002056:Burns / Q000601:surgery; D002490:Central Nervous System / Q000293:injuries / Q000601:surgery; D002648:Child; D002649:Child Abuse; D002675:Child, Preschool; D004630:Emergencies; D005183:Failure to Thrive / Q000628:therapy; D005260:Female; D050723:Fractures, Bone / Q000601:surgery; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D012742:Sex Offenses; D013514:Surgical Procedures, Operative