Predictors of increasing injury severity across suspected recurrent episodes of non-accidental trauma: a retrospective cohort study

BMC Pediatrics
Jonathan ThackerayKatherine J Deans

Abstract

Little is known about how the severity of injury changes with recurrent events of suspected non-accidental trauma (NAT). Our objective was to determine risk factors for escalating severity of injury in children with multiple events of suspected NAT. This retrospective longitudinal cohort study included children from a pediatric Medicaid accountable care organization with ≥ 1 non-birth related episode containing an International Classification of Diseases, Ninth Revision, Clinical Modification or Current Procedural Terminology code for NAT or a skeletal survey between 2007 and 2011. Subsequent potential NAT events were defined as independent episodes with codes for either NAT, a skeletal survey, or injuries suspicious for abuse. Severity of injury was calculated using the New Injury Severity Score (NISS). Multivariable Cox proportional hazards regression modeling was used with results expressed as hazard ratios and 95 % confidence intervals. Of the 914 children with at least one suspected NAT event, 39 % had at least one suspected recurrent NAT event; 12 % had 2 events and 5 % had ≥ 3 events during follow-up. Factors associated with an increased risk for a recurrent episode of suspected NAT with higher NISS were living in a rura...Continue Reading

References

Jan 1, 1996·Lifetime Data Analysis·J K Grønnesby, O Borgan
Apr 29, 1998·The Journal of Trauma·F D BrennemanD A Redelmeier
Feb 24, 1999·JAMA : the Journal of the American Medical Association·C JennyT C Hay
Dec 3, 2005·Pediatrics·Eron Y FriedlaenderEvaline A Alessandrini
Dec 20, 2007·Pediatric Emergency Care·Jonathan David Thackeray
May 29, 2008·Revista latino-americana de enfermagem·Lilia de Souza NogueiraRegina Márcia Cardoso de Sousa
Mar 13, 2013·Pediatrics·Lynn K SheetsPippa Simpson
Aug 14, 2013·The Journal of Trauma and Acute Care Surgery·Katherine J DeansPeter C Minneci

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Citations

Jul 3, 2019·Journal of Forensic Sciences·Miriam E Soto MartinezChristian M Crowder
Jan 19, 2021·International Journal of Pediatrics·Taylor Goldman, Sathyaprasad Burjonrappa
Jul 19, 2021·American Journal of Surgery·Adil A ShahMikael Petrosyan
Jul 22, 2021·Journal of Pediatric Ophthalmology and Strabismus·Ajay S KotiJonathan D Thackeray
Jul 29, 2021·Child Maltreatment·Meghan E ShanahanMolly C Berkoff
Nov 18, 2021·JAMA Network Open·Flora BlangisUNKNOWN European Confederation of Primary Care Paediatricians (ECPCP) research group
May 21, 2020·Pediatric Emergency Care·Emily A EismannJonathan D Thackeray

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BETA
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