[Child abuse in the Emergency department: Epidemiology, management, and follow-up]

Area of Science:

• Pediatric Emergency Medicine
• Child Abuse and Neglect Research
• Public Health

Background:

• Child abuse is a significant public health concern requiring accurate diagnosis and management in emergency settings.
• Understanding the clinical and epidemiological characteristics of suspected child abuse is crucial for effective intervention.

Purpose of the Study:

• To detail the clinical and epidemiological features of suspected child abuse cases.
• To analyze the management and follow-up strategies for these cases within a pediatric emergency unit.

Main Methods:

• A retrospective, observational study was conducted over a 10-year period (2008-2017) at a single center.
• Data on clinical, epidemiological, and follow-up aspects were collected for patients under 16 years old with suspected child abuse.
• Descriptive, bivariate, and multivariate analyses were performed.

Main Results:

• Out of 570,648 emergency patients, 404 (0.07%) had suspected child abuse. Physical abuse was most common (40.3%).
• Median age was 4.3 years; girls had higher odds of sexual abuse (OR 3.71), while boys had higher odds of physical abuse (OR 1.72).
• Admission was required for 22% of cases, associated with age and abuse type. Over half (56%) needed follow-up, with specific types linked to mental health or social services.

Conclusions:

• Child abuse is more prevalent in preschool-aged children.
• Patient age and the type of abuse are significant factors determining the need for hospital admission.
• The nature of follow-up care is dictated by the specific type of child abuse identified.