Identifying Abuse and Neglect in Hospitalized Children With Burn Injuries.
BACKGROUND
The purpose of this study was to identify the pattern of injuries that relates to abuse and neglect in children with burn injuries.


METHODS
The Nationwide Readmissions Database for 2010-2014 was queried for all patients aged less than 18 y admitted with burn injuries. The primary outcome was child maltreatment identified at the index admission. The secondary outcome was readmission for maltreatment. A subgroup analysis was performed on patients without a diagnosis of maltreatment during the index admission. Multivariable logistic regression was performed for each outcome.


RESULTS
There were 57,939 admissions identified and 1960 (3.4%) involved maltreatment at the index admission. Maltreatment was associated with total body surface area burned >20% (odds ratio (OR) 2.79, P < 0.001) and burn of the lower limbs (OR 1.37, P < 0.001). Readmission for maltreatment was found in 120 (0.2%), and the strongest risk factor was maltreatment identified at the index admission (OR 5.11, P < 0.001). After excluding the patients with maltreatment identified at the index admission, 96 (0.17%) children were found to have a readmission for maltreatment that may have been present on the index admission and subsequently missed. The strongest risk factor was burn of the eye or ocular adnexa (OR 3.79, P = 0.001).


CONCLUSIONS
This study demonstrates that a portion of admissions for burn injuries in children could involve maltreatment that was undiagnosed. Identifying these at-risk individuals is critical to prevention efforts.
['Quiroz|Hallie J|HJ|', 'Parreco|Joshua P|JP|', 'Khosravani|Nima|N|', 'Thorson|Chad|C|', 'Perez|Eduardo A|EA|', 'Sola|Juan E|JE|', 'Rattan|Rishi|R|', 'Pizano|Louis R|LR|']
D000293:Adolescent D002056:Burns D002648:Child D002649:Child Abuse D002673:Child, Hospitalized D002675:Child, Preschool D005260:Female D006801:Humans D007223:Infant D007231:Infant, Newborn D008297:Male D000081006:Missed Diagnosis D010359:Patient Readmission D012307:Risk Factors D014481:United States
Burns Readmissions Child abuse