A retrospective cohort study of suspected child maltreatment cases resulting in hospitalization.
OBJECTIVE
Although the incidence and risk factors of child abuse have been well researched, there continues to be a need for large studies that provide information regarding the process of recognizing children whose health and lives are most seriously threatened by abuse and neglect, in particular children requiring hospitalization as a result of child abuse. The purpose of this study was to (1) describe differences in the type of injuries and illnesses of children hospitalized for abuse and neglect and (2) assess the relationship between in-hospital mortality and child maltreatment.


METHODS
For this retrospective cohort study, child maltreatment cases were identified using medical record databases of patients treated in all hospitals and trauma units in Illinois. A comparison group of children not suffering from suspected maltreatment were randomly selected and matched by age and data source to the suspected maltreatment cases.


METHODS
2656 children under the age of 13 years suspected of suffering maltreatment who were admitted to any hospital in Illinois between 2000 and 2009.


RESULTS
The analysis showed distinct patterns in injury, physical illness and psychological disorders for each subgroup of maltreatment cases. Among the cases of maltreatment 75.6% were discharged home, 2.9% into child protective services and 15.8% to an intermediate care facility. In the final multivariable conditional logistic regression model, children suffering maltreatment continued to have a higher odds of dying during hospitalization (adjusted OR=2.99; CI95%: 1.63, 5.45; p<0.001).


CONCLUSIONS
There were distinct diagnostic patterns and outcomes among suspected cases of child maltreatment admitted to Illinois hospitals over a 10-year period. This large retrospective cohort study confirms findings reported in many smaller studies and larger national cross-sectional surveys.
University of Illinois, School of Public Health, Division of Environmental and Occupational Health Sciences, Chicago, IL 60612, USA. lfriedman@tspri.org
Lee S
LS
Friedman
Shirley
S
Sheppard
Daniel
D
Friedman
D000293:Adolescent; D002648:Child; D002649:Child Abuse / Q000175:diagnosis / Q000401:mortality / Q000706:statistics & numerical data*; D002650:Child Abuse, Sexual / Q000706:statistics & numerical data; D002669:Child Welfare; D002675:Child, Preschool; D015331:Cohort Studies; D015897:Comorbidity; D005260:Female; D017052:Hospital Mortality; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D007087:Illinois / Q000453:epidemiology; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D016015:Logistic Models; D008297:Male; D011159:Population Surveillance; D012189:Retrospective Studies