title: Outcomes for children hospitalized with abusive versus noninflicted abdominal trauma.
abstract: BACKGROUND
  Abusive abdominal trauma (AAT) is the second leading cause of child abuse mortality. Previous outcome studies have been limited to data from trauma centers.
  
  
  OBJECTIVE
  The goals of this study were (1) to examine mortality, length of hospitalization, and hospital charges among a national sample of children hospitalized for AAT; and (2) to compare these outcomes with children with noninflicted abdominal trauma.
  
  
  METHODS
  Hospitalization data for children aged 0 to 9 years were obtained from the 2003 and 2006 Kids' Inpatient Database. Cases were identified using International Classification of Diseases, Ninth Revision, Clinical Modification and external cause of injury codes. Multivariable regression analyses were used to compare outcomes of children with AAT versus those with noninflicted injury.
  
  
  RESULTS
  Children with AAT were younger, and more often insured by Medicaid. Among children surviving to discharge, those with AAT had longer hospitalizations (adjusted mean [95% confidence interval (CI)] length of stay: 7.9 (6.6-9.3) vs 6.4 (6.1-6.7) days, P < .01) and higher charges (adjusted mean [95% CI] costs: $24 343 [$20 952-$28 567] vs $19 341 [$18 770-$20 131]; P < .01). Among children aged 1 to 9 years, those with AAT had higher mortality (adjusted rate [95% CI]: 9.2% [5.0%-16.1%] vs 2.7% [2.2%-3.2%], P < .01). There was no significant difference in mortality for children aged younger than 1 year.
  
  
  CONCLUSIONS
  Children hospitalized for AAT generally had poorer short-term outcomes compared with children with noninflicted abdominal trauma. Studies to explain these differences are needed. In addition, efforts to prevent these injuries and to assist families at risk should be supported.
authors.affiliation: Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, MD 21201, USA. wlane@epi.umaryland.edu
authors.forename: Wendy Gwirtzman
authors.initials: WG
authors.lastname: Lane
authors.forename: Irwin
authors.initials: I
authors.lastname: Lotwin
authors.forename: Howard
authors.initials: H
authors.lastname: Dubowitz
authors.forename: Patricia
authors.initials: P
authors.lastname: Langenberg
authors.forename: Patricia
authors.initials: P
authors.lastname: Dischinger
mesh_terms: D000007:Abdominal Injuries / Q000453:epidemiology* / Q000209:etiology / Q000628:therapy; D002648:Child; D002649:Child Abuse / Q000401:mortality*; D002675:Child, Preschool; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007902:Length of Stay / Q000706:statistics & numerical data*; D008297:Male; D011379:Prognosis; D014193:Trauma Centers / Q000706:statistics & numerical data*; D014481:United States / Q000453:epidemiology