A closer look at non-accidental trauma: Caregiver assault compared to non-caregiver assault.
OBJECTIVE
The purpose of this study was to examine the outcomes of non-accidental trauma (NAT) patients compared to other trauma (OT) patients across the state of Florida. In addition, NAT and OT patients with a mechanism of injury of assault were further analyzed.


METHODS
A statewide database was reviewed from January 2010 to December 2014 for patients aged 0-18years who presented following trauma. Patients were sorted by admitting diagnosis into two groups: rule out NAT and all other diagnoses. Patients with a mechanism of assault were subanalyzed and outcomes were compared.


RESULTS
There were 46,557 patients included. NAT patients were younger, had more severe injuries and had a higher mortality rate compared to OT patients. Assault was the mechanism of injury in 95% of NAT patients. NAT assault patients were younger, required more intensive care unit (ICU) resources, and had a higher mortality rate compared to other assault patients.


CONCLUSIONS
Non-accidental trauma patients require more resources and have a higher mortality rate compared to accidental trauma patients, and these differences remain even when controlling for the mechanism of injury.


METHODS
III.
Johns Hopkins All Children's Hospital, Outpatient Care Center, 601 5th Street South, Dept 70-6600, 3rd Floor, Saint Petersburg, FL 33701, USA. Electronic address: clitz1@jhmi.edu.
Cristen N
CN
Litz
University of South Florida, Morsani College of Medicine, 1 Tampa General Circle, G417, Tampa, FL 33606, USA. Electronic address: dciesla@health.usf.edu.
David J
DJ
Ciesla
Johns Hopkins All Children's Hospital, Outpatient Care Center, 601 5th Street South, Dept 70-6600, 3rd Floor, Saint Petersburg, FL 33701, USA. Electronic address: Paul.Danielson@jhmi.edu.
Paul D
PD
Danielson
Johns Hopkins All Children's Hospital, Outpatient Care Center, 601 5th Street South, Dept 70-6600, 3rd Floor, Saint Petersburg, FL 33701, USA. Electronic address: Nicole.Chandler@jhmi.edu.
Nicole M
NM
Chandler
D000059:Accidents / Q000401:mortality / Q000706:statistics & numerical data; D000293:Adolescent; D017028:Caregivers; D002648:Child; D002649:Child Abuse / Q000175:diagnosis* / Q000401:mortality / Q000706:statistics & numerical data / Q000628:therapy; D002675:Child, Preschool; D005260:Female; D005431:Florida / Q000453:epidemiology; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D012189:Retrospective Studies; D016896:Treatment Outcome; D014947:Wounds and Injuries / Q000175:diagnosis / Q000209:etiology* / Q000401:mortality / Q000628:therapy
Accidental trauma; Assault; Child abuse; Non-accidental trauma; Pediatric