Department of Pediatrics, Yale School of Medicine, Post Office Box 208064, 333 Cedar St, New Haven, CT 06520-8064, USA.
Pediatrics. 2012 Nov;130(5):e847-52. doi: 10.1542/peds.2012-0922. Epub 2012 Oct 1.
Although US child protective services data showed a 55% decrease in the national incidence of substantiated physical abuse from 1992 to 2009, no study has tracked the occurrence of serious injuries due to physical abuse. This study examined changes in the incidence of serious injuries due to physical abuse in hospitalized children from 1997 to 2009.
The Kids' Inpatient Database, a sample of discharges from hospitals in the United States, includes International Classification of Diseases, Ninth Revision, Clinical Modification diagnosis and external cause of injury codes; it was prepared every 3 years from 1997 to 2009. Cases of serious physical abuse (eg, abusive head injury) were identified by using injury codes (800-959) and codes for abuse (995.50, 0.54, 0.55, and 0.59), selected assault codes (E960-966, 968), or perpetrator of abuse (E967). The weighted number of hospitalizations due to serious physical abuse was used to calculate the national incidence, and χ(2) for linear trend compared over time the incidence for children <18 years and <1 year of age.
The incidence per 100,000 children <18 years of age increased 4.9%: 6.1 (95% confidence interval = 5.4-6.8) for 1997, 6.0 (5.2-6.7) for 2000, 6.0 (5.3-6.7) for 2003, 6.1 (5.3-6.8) for 2006, and 6.4 (5.7-7.2) for 2009 (P < .01). The incidence for children <1 year of age increased 10.9% (P < .05).
Over 12 years, when substantiated physical abuse was declining, there was a small increase in the incidence of serious physical abuse in children <18 and <1 year of age.
尽管美国儿童保护服务机构的数据显示，1992 年至 2009 年全国经证实的身体虐待发生率下降了 55%，但尚无研究跟踪因身体虐待导致的严重伤害的发生情况。本研究旨在调查 1997 年至 2009 年期间因身体虐待住院的儿童中严重伤害的发生率变化。
“儿童住院数据库”是美国医院出院患者的样本，包含国际疾病分类，第九修订版，临床修正诊断和损伤外部原因代码；该数据库每 3 年编制一次，时间范围为 1997 年至 2009 年。严重身体虐待（例如，虐待性头部损伤）的病例是通过使用损伤代码（800-959）和虐待代码（995.50、0.54、0.55 和 0.59）、选择的攻击代码（E960-966、968）或虐待实施者代码（E967）来确定的。使用严重身体虐待住院的加权人数来计算全国发病率，并通过线性趋势 χ(2)检验比较不同年龄组（＜18 岁和＜1 岁）随时间的发病率。
＜18 岁儿童的发病率每 10 万人增加 4.9%：1997 年为 6.1（95%置信区间=5.4-6.8），2000 年为 6.0（5.2-6.7），2003 年为 6.0（5.3-6.7），2006 年为 6.1（5.3-6.8），2009 年为 6.4（5.7-7.2）（P＜0.01）。＜1 岁儿童的发病率增加了 10.9%（P＜0.05）。
在 12 年期间，当经证实的身体虐待率下降时，＜18 岁和＜1 岁儿童中严重身体虐待的发生率略有上升。
