title: Frequency and predictors of medically attended injuries in HIV-infected children.
abstract: The extent to which medically attended injuries complicate the clinical course of HIV-infected (HIV+) children is unknown. In a cohort of HIV+ children delivered from 1985 to 1990 and aged less than 60 months, we determined medically attended injuries per 100 child-years, Injury Severity Scores (ISS), and predictors of medically attended injuries by using New York State Medicaid claims from 1986 to 1992 linked to birth certificates. Injury rates and ISS were compared to those of a population of black, inner city children aged less than 60 months from emergency room records. HIV+ children had slightly more injuries (19.3 vs. 16.8/100 child-years) but similar ISS (2.4 vs. 2.3). Predictors of injuries in HIV+ children included younger maternal age (24/100 child-years, p = 0.008) and delivery outside of New York City (29/100 child-years, p = 0.02). Illicit drug use and alcohol use were associated with greater ISS while cocaine use was associated with a higher rate of possibly intentional injuries. Medically attended injuries affected one in five HIV+ children in our cohort annually, slightly more than the comparison population. Specific maternal and birth characteristics such as substance abuse and younger age at delivery may help target at-risk children.
authors.affiliation: Division of General Internal Medicine, Jefferson Medical College of Thomas Jefferson University, Philadelphia, PA 19107-5083, USA.
authors.forename: B J
authors.initials: BJ
authors.lastname: Turner
authors.forename: J
authors.initials: J
authors.lastname: Cocroft
authors.forename: W W
authors.initials: WW
authors.lastname: Hauck
authors.forename: D F
authors.initials: DF
authors.lastname: Schwarz
authors.forename: R
authors.initials: R
authors.lastname: Casey
mesh_terms: D000163:Acquired Immunodeficiency Syndrome / Q000150:complications*; D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000704:Analysis of Variance; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D005260:Female; D015658:HIV Infections / Q000150:complications*; D006801:Humans; D007231:Infant, Newborn; D007236:Infant, Small for Gestational Age; D015601:Injury Severity Score; D008297:Male; D008423:Maternal Age; D011237:Predictive Value of Tests; D011247:Pregnancy; D012307:Risk Factors; D019966:Substance-Related Disorders / Q000150:complications*; D014947:Wounds and Injuries / Q000150:complications* / Q000453:epidemiology