Risk of Injury-Related Readmission Varies by Initial Presenting-Hospital Type Among Children at High Risk for...

Area of Science:

• Pediatric medicine
• Trauma surgery
• Child abuse research

Background:

• Children experiencing physical abuse may present with subtle injuries initially.
• Delayed recognition of abuse can lead to severe, future harm.

Purpose of the Study:

• To identify young children with high-risk diagnoses for physical abuse.
• To characterize initial hospital presentations for these children.
• To assess the link between initial hospital type and subsequent injury admissions.

Main Methods:

• Analysis of Florida healthcare data (2009-2014) for children under 6 with high-risk abuse diagnoses.
• Categorization of initial hospitals: community, adult/combined trauma, or pediatric trauma centers.
• Multivariable logistic regression to evaluate associations with subsequent injury admissions within one year.

Main Results:

• 8626 high-risk children were included; 68% initially presented to community hospitals.
• 3% of children experienced subsequent injury admissions within a year.
• Initial presentation to community hospitals (OR 4.03) or adult/combined trauma centers (OR 3.19) increased risk of subsequent admissions compared to pediatric trauma centers.

Conclusions:

• Most high-risk children initially present to non-trauma centers.
• Pediatric trauma center evaluation is associated with reduced risk of subsequent injury.
• Enhanced collaboration between community hospitals and pediatric trauma centers is crucial for early identification and protection.