University of Illinois, School of Public Health, Division of Environmental and Occupational Health Sciences, Chicago, IL 60612, USA.
Injury. 2012 Nov;43(11):1881-7. doi: 10.1016/j.injury.2012.07.192. Epub 2012 Aug 16.
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.
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.
2656 children under the age of 13 years suspected of suffering maltreatment who were admitted to any hospital in Illinois between 2000 and 2009.
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).
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.
尽管儿童虐待的发生率和风险因素已经得到了充分的研究，但仍需要进行大规模的研究，提供有关识别那些健康和生命受到虐待和忽视最严重威胁的儿童的信息，特别是因虐待而需要住院的儿童。本研究的目的是：(1)描述因虐待和忽视而住院的儿童的伤害和疾病类型的差异；(2)评估住院死亡率与儿童虐待之间的关系。
本回顾性队列研究使用伊利诺伊州所有医院和创伤单位的患者病历数据库来确定儿童虐待病例。选择一组未遭受疑似虐待的儿童作为对照组，并按年龄和数据源与疑似虐待病例进行匹配。
2000 年至 2009 年期间在伊利诺伊州任何一家医院就诊的 2656 名年龄在 13 岁以下的疑似受虐待儿童。
分析显示，每种虐待病例亚组的伤害、身体疾病和心理障碍模式都不同。在虐待病例中，75.6%的患儿出院回家，2.9%的患儿被送入儿童保护服务机构，15.8%的患儿被送往中级护理机构。在最终的多变量条件逻辑回归模型中，受虐待的儿童在住院期间死亡的几率仍然更高（调整后的比值比=2.99；95%CI：1.63，5.45；p<0.001）。
在伊利诺伊州医院接受治疗的 10 年间，疑似儿童虐待的病例存在明显的诊断模式和结局。这项大型回顾性队列研究证实了许多较小的研究和更大的全国横断面调查报告的结果。
