Introduction: Injury is the number one cause of death in children. This study sought to examine causes, intentionality, and outcomes of injury in children ages 0-5 admitted to a community trauma center in southeastern NC. Methods: Using medical record and trauma registry data on trauma admissions between 1994 and 1999, five reviewers independently classified injuries into abuse, neglect, and unintentional injury using a predetermined system. Final classification was based on agreement by three of five reviewers. Results: One hundred four of 4,455 trauma admissions were in children aged 0-5. ICD9-CM E-codes indicated: 37% transport related, 34% falls, 24% other unintentional, 5% assault, and 1% firearm. Among transportation-related inquiries, 56% were not properly restrained. Over half of all children were injured as a result of abuse (12%) or neglect (46%). A multiple logistic regression model (MLR) showed that young children (age 0-3) and children with Medicaid/self-pay were significantly more likely to be abused or neglected. Controlling for insurance status and age, there was no racial difference in abuse/neglect. One in four children classified as abused died, as did 4% of those classified as neglected, and none of those classified as unintentional. About 80% classified as abused had a documented Department of Social Services referral compared with only 21% of those neglected. Conclusion: Over half of the injuries were classified as neglect or abuse, which contributed significantly to early mortality. Improper motor vehicle restraint was also a serious problem. Interventions are needed to educate both caregivers and clinicians.
Learning Objectives: 1. Describe the external causes of child injury in this study group. 2. Describe the results of the intentionality classification. 3. List patient factors associated with the classification of abuse and neglect from the study. 4. Articulate the outcomes of child injury for intentionality groups.
Keywords: Child Health, Injury
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.