Maltreatment-Related Emergency Department Visits Among Children 0 to 3 Years Old in the United States

Area of Science:

• Pediatrics
• Public Health
• Emergency Medicine

Background:

• The emergency department (ED) is a critical access point for identifying and managing child maltreatment.
• Existing literature lacks comprehensive national data on maltreatment-related ED visits for young children.

Purpose of the Study:

• To provide systematic, national estimates of maltreatment-related ED visits in the U.S. for children aged 3 years and younger.
• To describe the clinical and demographic profiles of these children.
• To assess the association between maltreatment and adverse outcomes in the ED.

Main Methods:

• Utilized the Nationwide Emergency Department Sample (NEDS) database from 2006 to 2011.
• Identified maltreatment using International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) diagnostic codes.
• Classified maltreatment into physical abuse, sexual abuse, neglect, and poly-victimization.

Main Results:

• Approximately 10,095 children experiencing maltreatment (0.1%) and 129,807 likely experiencing maltreatment (1.2%) visited the ED annually.
• Maltreatment was significantly associated with increased risk of injury, hospitalization, and death.
• Physical abuse was the most common explicit diagnosis (33/100,000), while neglect was most common for likely maltreatment (436/100,000).

Conclusions:

• The NEDS is a valuable resource for national child maltreatment surveillance.
• Maltreatment poses severe risks to young children presenting to the ED.
• Targeted interventions and improved identification are crucial for this vulnerable population.