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Prevalence of Adverse Childhood Experiences in a Pediatric Emergency Department: Support for Trauma-Informed

Elise Alves Graber1, Amy Puchalski, Christyn Magill

  • 1From the Department of Emergency Medicine, Atrium Health's Carolinas Medical Center, Charlotte, NC.

Pediatric Emergency Care
|July 29, 2022
PubMed

Insights

Adverse childhood experiences (ACEs) affect 40.2% of pediatric emergency department patients, similar to national rates. ACE exposure did not significantly correlate with emergency department recidivism in this study.

Area of Science:

  • Pediatric Emergency Medicine
  • Public Health
  • Childhood Trauma Research

Background:

  • Adverse Childhood Experiences (ACEs) are linked to long-term negative health outcomes.
  • National data indicates significant prevalence of ACEs among US children.
  • Understanding ACEs prevalence in clinical settings is crucial for intervention.

Purpose of the Study:

  • To determine the prevalence of ACE exposure in pediatric emergency department (ED) patients.
  • To examine the association between ACE exposure and ED recidivism.

Main Methods:

  • A convenience sample of 500 children (0-17 years) in a pediatric ED were assessed for ACEs using the National Survey of Children's Health.
  • Prospective chart review collected 1-year ED utilization data post-survey.
  • Relative risk was calculated to analyze the relationship between ACE exposure and ED recidivism.

Main Results:

  • 40.2% of pediatric ED patients reported ACE exposure, mirroring national prevalence.
  • The most common ACEs were poverty (20.8%), divorce/separation (18.2%), and household mental illness (7.2%).
  • No significant association was found between ACE exposure and high ED recidivism.

Conclusions:

  • ACEs prevalence in this pediatric ED population is consistent with national figures.
  • This population warrants attention for ACEs risk factor mitigation.
  • ACE exposure did not influence ED recidivism during a period of reduced ED volumes (COVID-19 pandemic).
Abstract

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