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Published on: February 23, 2024
Risk factors for nonaccidental burns in children
Dalya M Ferguson1,2,3, Tayler D Parker1, Vanessa E Marino1
1Department of Pediatric Surgery, McGovern Medical School at the University of Texas Health Science Center at Houston, 6431 Fannin St, MSB 5.256, Houston, TX 77030.
Insights
Pediatric nonaccidental burns are associated with caretaker involvement in Child Protective Services (CPS) and non-Hispanic Black race. Further research is needed to confirm these risk factors for child abuse and neglect.
Area of Science:
- Pediatric Burn Research
- Child Abuse and Neglect Studies
- Public Health
Background:
- Pediatric nonaccidental burns, often resulting from abuse or neglect, lack well-defined baseline risk factors.
- Understanding these factors is crucial for early identification and intervention to prevent severe harm to children.
Purpose of the Study:
- To evaluate baseline characteristics of pediatric nonaccidental burn patients and their primary caretakers.
- To identify potential risk factors associated with nonaccidental burns in children.
Main Methods:
- A retrospective cohort study of pediatric burn patients (<17 years) was conducted over five years.
- Nonaccidental burn was defined as burns resulting from abuse or neglect, confirmed by child protection teams.
- Univariate and multivariate analyses were used to assess risk factors.
Main Results:
- Of 489 burn patients, 9.6% were classified as nonaccidental burns.
- Nonaccidental burns were significantly associated with prior Child Protective Services (CPS) involvement for both the child and caretaker.
- Non-Hispanic Black children exhibited higher rates of CPS referral and nonaccidental burn diagnosis.
Conclusions:
- Caretaker history of CPS involvement and non-Hispanic Black race/ethnicity are associated with increased odds of pediatric nonaccidental burns.
- Prospective research is recommended to ascertain if these are true risk factors or influenced by confounders like socioeconomic status.
Background:
The relative influences of baseline risk factors for pediatric nonaccidental burns have not been well described. We evaluated baseline characteristics of pediatric nonaccidental burn patients and their primary caretakers.
Methods:
A single-center retrospective cohort study was conducted of pediatric (age < 17) burn patients from July 1, 2013, to June 30, 2018. The primary outcome was nonaccidental burn, defined as burn secondary to abuse or neglect as determined by the inpatient child protection team or Child Protective Services. Univariate and multivariate analyses were performed.
Results:
Of 489 burn patients, 47 (9.6%) suffered nonaccidental burns. Nonaccidental burn patients more frequently had a history of Child Protective Services involvement (48.9% vs 9.7%, P < .001), as did their primary caretakers (59.6% vs 10.9%, P < .001). Non-Hispanic black children had higher rates of Child Protective Services referral (50.7% vs 26.7%, P < .001) and nonaccidental burn diagnosis (18.9% vs 5.6%, P < .001) than children of other races/ethnicities. On multivariate analysis, caretaker involvement with CPS (odds ratio 7.53, 95% confidence interval 3.38-16.77) and non-Hispanic black race/ethnicity (odds ratio 3.28, 95% confidence interval 1.29-8.36) were associated with nonaccidental burn.
Conclusion:
Caretaker history of Child Protective Services involvement and non-Hispanic black race/ethnicity were associated with increased odds of pediatric nonaccidental burn. Prospective research is necessary to determine whether these represent true risk factors for nonaccidental burn or are the result of other confounders, such as socioeconomic status.
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