What Happens after the Hospital? An Analysis of Longitudinal Care Needs in Children Treated for Child Physical Abuse
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Read the article on jpedsurg.org ↗Article · Jun 2021 · 1 min read
In brief
In brief
Retrospective study of 401 child physical abuse victims at a Level I pediatric trauma center reveals 88% compliance with post-discharge appointments, with children in CPS custody showing higher follow-up rates (90% vs 82%). Complex injuries require extended care beyond one year, highlighting need for coordinated multidisciplinary management protocols.
Written by the GCMD Library team from the article.
Background
: Victims of child physical abuse (CPA) undergo stabilization and social evaluation during initial management. Current data guides the initial hospital course, but few studies evaluate post-hospital care. The aim of this study was to evaluate compliance with recommended post-discharge visits.
Methods
: A retrospective review of our trauma database at a Level I pediatric trauma center from 2014-2018 was performed. Data included demographics, injuries, and longitudinal outcomes. Descriptive statistics and univariate analyses were performed.
Results
: There were 401 patients (409 unique presentations). Median age was 7 months. Mortality was 6%. Ninety-five percent (358/377) had recommended appointments with multiple specialty services. Compliance with all recommended visits during the first year after injury was 88%. Patients with complex injuries were as likely to comply with recommended follow-up [72% vs. 67%, p = 0.4]; however, they were more likely to still be receiving care at 1 year (58% vs. 14%, p=0.0001). Those discharged to CPS custody were more likely to be compliant with their follow-up (90% vs. 82%, p = 0.03).
Conclusion
: Patients significantly injured due to CPA require more post-hospital care over time. CPA management guidelines should include a mechanism to provide resources to these patients and manage multiple coordinating consultants.