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Emergency Department Presentations for Injuries Following Agency-Notified Child Maltreatment: Results From the
Mike Trott1,2, Claudia Bull1,2,3, Urska Arnautovska1,2
1Princess Alexandra Hospital Southside Clinical Unit, Greater Brisbane Clinical School, Medical School, The University of Queensland, Brisbane, QLD, Australia.
Insights
Child maltreatment (CM) is linked to higher emergency department (ED) visits for injuries in adulthood. These findings suggest ED visits may indicate underlying risks or abuse, particularly for women.
Area of Science:
- Public Health
- Epidemiology
- Childhood Trauma Research
Background:
- Child maltreatment (CM) is a known risk factor for adverse adult health outcomes, including self-harm and suicidal behaviors.
- The association between CM and emergency department (ED) presentations for non-deliberate self-harm (DSH) injuries remains under-investigated.
Purpose of the Study:
- To examine the association between agency-reported CM and subsequent ED presentations for injuries.
- To explore potential sex differences in the association between CM and ED injury presentations.
Main Methods:
- Utilized a birth cohort study linked to administrative health data.
- Included agency-reported and substantiated CM notifications and ED presentations for non-DSH related injuries.
- Performed adjusted analyses on 6087 individuals, including moderation analyses for sex differences.
Main Results:
- Any agency-reported CM notification was significantly associated with increased odds of ED presentation for injuries (adjusted odds ratio [aOR] = 1.57).
- Women showed significantly higher odds of notified and substantiated physical abuse, substantiated emotional abuse, and multiple types of substantiated abuse compared to men.
- ED injury presentations may serve as a proxy for risky behaviors, disguised DSH/suicidal behaviors, or physical abuse.
Conclusions:
- Child maltreatment is a significant predictor of adult emergency department visits for injuries.
- Findings suggest ED injury presentations could indicate underlying risks, abuse, or disguised suicidal behaviors.
- The heightened association in women warrants further investigation into interpersonal violence and victimization.
Abstract:
Child maltreatment (CM) is associated with negative health outcomes in adulthood, including deliberate self-harm (DSH), suicidal behaviours, and victimisation. It is unknown if associations extend to emergency department (ED) presentations for non-DSH related injuries. Birth cohort study data was linked to administrative health data, including ED presentations for non DSH related injuries and agency-reported and substantiated notifications for CM. Adjusted analyses (n = 6087) showed that any type of agency-reported notification for CM was significantly associated with increased odds of ED presentation for injuries (aOR = 1.57; 95% CI 1.32-1.87). In moderation analyses, women yielded significantly higher odds of notified and substantiated physical abuse, substantiated emotional abuse, and being subject to more than one type of substantiated abuse than males. ED presentations for injuries could be a proxy for risky behaviours, disguised DSH/suicidal behaviours, or physical abuse. The consistent findings in women may point to victimisation via interpersonal violence.
