The shifting trends in the epidemiology and risk factors of non-accidental fractures in children
Copyright © 2024 Elsevier Ltd. All rights reserved..
BACKGROUND: Fractures are a common presentation of non-accidental trauma (NAT) in the pediatric population. However, the presentation could be subtle, and a high degree of suspicion is needed not to miss NAT.
OBJECTIVE: To analyze a comprehensive database, providing insights into the epidemiology of fractures associated with NAT.
PARTICIPANTS AND SETTING: The TriNetX Research Network was utilized for this study, containing medical records from 55 healthcare organizations. TriNetX was queried for all visits in children under the age of 6 years from 2015 to 2022, resulting in a cohort of over 32 million.
METHODS: All accidental and non-accidental fractures were extracted and analyzed to determine the incidence, fracture location, and demographics of NAT. Statistical analysis was done on a combination of Python and Epipy.
RESULTS: Overall, 0.36 % of all pediatric patients had a diagnosis of NAT, and 4.93 % of fractures (34,038 out of 689,740 total fractures) were determined to be non-accidental. Skull and face fractures constituted 17.9 % of all NAT fractures, but rib/sternum fractures had an RR = 6.7 for NAT. Children with intellectual and developmental disability (IDD) or autism spectrum disorder (ASD) had a 9 times higher risk for non-accidental fractures. The number of non-accidental fractures significantly increased after 2019.
CONCLUSIONS: The study findings suggest that nearly 1 out of all 20 fractures in children under age 6 are caused by NAT, and that rib/sternum fractures are most predictive of an inflicted nature. The study also showed a significant increase in the incidence of NAT, during and after the pandemic.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2024 |
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| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:149 |
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| Enthalten in: |
Child abuse & neglect - 149(2024) vom: 30. März, Seite 106692 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Baghdadi, Soroush [VerfasserIn] |
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| Links: |
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| Themen: |
Child abuse |
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| Anmerkungen: |
Date Completed 12.03.2024 Date Revised 27.03.2024 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1016/j.chiabu.2024.106692 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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NLM368850013 |
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| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2024 Elsevier Ltd. All rights reserved. | ||
| 520 | |a BACKGROUND: Fractures are a common presentation of non-accidental trauma (NAT) in the pediatric population. However, the presentation could be subtle, and a high degree of suspicion is needed not to miss NAT | ||
| 520 | |a OBJECTIVE: To analyze a comprehensive database, providing insights into the epidemiology of fractures associated with NAT | ||
| 520 | |a PARTICIPANTS AND SETTING: The TriNetX Research Network was utilized for this study, containing medical records from 55 healthcare organizations. TriNetX was queried for all visits in children under the age of 6 years from 2015 to 2022, resulting in a cohort of over 32 million | ||
| 520 | |a METHODS: All accidental and non-accidental fractures were extracted and analyzed to determine the incidence, fracture location, and demographics of NAT. Statistical analysis was done on a combination of Python and Epipy | ||
| 520 | |a RESULTS: Overall, 0.36 % of all pediatric patients had a diagnosis of NAT, and 4.93 % of fractures (34,038 out of 689,740 total fractures) were determined to be non-accidental. Skull and face fractures constituted 17.9 % of all NAT fractures, but rib/sternum fractures had an RR = 6.7 for NAT. Children with intellectual and developmental disability (IDD) or autism spectrum disorder (ASD) had a 9 times higher risk for non-accidental fractures. The number of non-accidental fractures significantly increased after 2019 | ||
| 520 | |a CONCLUSIONS: The study findings suggest that nearly 1 out of all 20 fractures in children under age 6 are caused by NAT, and that rib/sternum fractures are most predictive of an inflicted nature. The study also showed a significant increase in the incidence of NAT, during and after the pandemic | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Child abuse | |
| 650 | 4 | |a Epidemiology | |
| 650 | 4 | |a Fracture | |
| 650 | 4 | |a Non-accidental trauma | |
| 650 | 4 | |a Pediatric orthopaedics | |
| 650 | 4 | |a Pediatric trauma | |
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| 700 | 1 | |a Torres-Izquierdo, Beltran |e verfasserin |4 aut | |
| 700 | 1 | |a Pereira, Daniel E |e verfasserin |4 aut | |
| 700 | 1 | |a Gonuguntla, Rishi |e verfasserin |4 aut | |
| 700 | 1 | |a Mittal, Mehul |e verfasserin |4 aut | |
| 700 | 1 | |a Hosseinzadeh, Pooya |e verfasserin |4 aut | |
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