Telethon Institute for Child Health Research, University of Western Australia, 100 Roberts Road, Subiaco 6008, Perth, Western Australia, Australia.
Child Abuse Negl. 2010 Nov;34(11):823-32. doi: 10.1016/j.chiabu.2010.04.003.
To investigate the prevalence, trends, and characteristics of maltreatment and assault related hospital admissions and deaths among children; and identify common injuries and conditions associated with these admissions using routinely collected morbidity and mortality data.
A retrospective cohort study of all children aged 0-17 years in Western Australia from 1980 to 2005 was identified from linked de-identified population level data. Annual trends in prevalence of assault and maltreatment related admissions were calculated and child characteristics were investigated using logistic regression models.
Assault admissions more than doubled from 2.8 per 10,000 children in 1981 to 6.1 per 10,000 in 2005 (p<0.0001) and maltreatment admissions rose from 0.7 per 10,000 children in 1981 to 1.3 per 10,000 in 2005 (p<0.0001). Males aged greater than 12 years were at greater risk of an assault, while children aged less than 6 years were more likely to be at risk of maltreatment as well as those from greater disadvantaged backgrounds. Aboriginal children were more likely to be identified with assault and maltreatment compared to non-Aboriginal children. Common indicators of assault admissions included injuries of the skull and facial bones, intracranial, wrist, hand, and abdominal injuries. Children with maltreatment-related admissions were more likely to have superficial head or abdominal injuries and a high proportion had infectious and parasitic diseases, particularly intestinal infections. Many of these cases were associated with factors influencing health status, particularly socioeconomic and psychosocial circumstances.
There has been a steady increase in the prevalence of assault and maltreatment related admissions. Specific child characteristics and injuries associated with child assault and maltreatment-related admissions have been identified using routinely collected morbidity data and may be utilized as potential indicators for identifying and monitoring child abuse and neglect.
Broadening child maltreatment surveillance to children's admissions for assault and maltreatment is an important public health initiative which can be improved by the increased use of external cause codes. Health data is collected using international coding standards enhancing comparability across states and countries and has clinical implications in highlighting injuries associated with child abuse and neglect.
调查儿童虐待和袭击相关住院和死亡的发生率、趋势和特征；并利用常规收集的发病率和死亡率数据，确定与这些住院相关的常见伤害和疾病。
本研究采用回顾性队列研究，纳入了 1980 年至 2005 年期间西澳大利亚州所有 0-17 岁儿童的人群水平数据。使用逻辑回归模型对袭击和虐待相关入院的年度流行率趋势和儿童特征进行了调查。
袭击入院率从 1981 年的每 10,000 名儿童 2.8 例增加到 2005 年的每 10,000 名儿童 6.1 例（p<0.0001），虐待入院率从 1981 年的每 10,000 名儿童 0.7 例增加到 2005 年的每 10,000 名儿童 1.3 例（p<0.0001）。12 岁以上的男性儿童发生袭击的风险更高，而 6 岁以下的儿童更容易受到虐待，并且来自劣势背景的儿童风险更高。与非原住民儿童相比，原住民儿童更有可能被诊断为遭受袭击和虐待。袭击入院的常见指标包括颅骨和面部骨骼、颅内、腕部、手部和腹部损伤。遭受虐待相关入院的儿童更有可能出现头部或腹部浅表损伤，且有相当比例的儿童患有传染病和寄生虫病，尤其是肠道感染。这些病例中的许多都与影响健康状况的因素有关，特别是社会经济和心理社会环境。
儿童虐待和袭击相关住院的发生率稳步上升。利用常规收集的发病率数据，确定了与儿童袭击和虐待相关入院相关的特定儿童特征和损伤，这些数据可能作为识别和监测儿童虐待和忽视的潜在指标。
扩大儿童虐待监测范围，纳入儿童因袭击和虐待而入院，是一项重要的公共卫生举措，可以通过增加外部原因代码的使用来加以改进。健康数据是按照国际编码标准收集的，提高了各州和国家之间的可比性，并在强调与儿童虐待和忽视相关的损伤方面具有临床意义。
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