Longitudinal care needs in children treated for child physical abuse | Total of 401 patients presented with CPA. 60% male. | Median age 7 months. | 67% < 1 year of age. | 5-year | Retrospective review of trauma database at a single Level I pediatric trauma center for patients who were victims of child physical abuse (CPA) between ages 0-17. | 31% Required ICU admit | Most common injuries: TBI (43%), extremity fractures (34%), skull fractures (25%). | 24% Had long-term sequelae due to trauma. | 88% Compliance with recommended visits in 1st year post injury. | 58% vs 14% Patients with complex injuries more likely to be receiving care at 1 year. | Conclusion: Patients significantly injured due to CPA require more post-hospital care. | https://pubmed.ncbi.nlm.nih.gov/34167802/ | Source: Texas Children's Hospital and Baylor College of Medicine, Houston, TX | @EmTombash | @CPSNet | @RodGerardo
Longitudinal care needs in children treated for child physical abuse
Infographic · Oct 2021 · 1 min read
In brief
In brief
Retrospective study of 401 child physical abuse victims found 88% compliance with first-year follow-up appointments, with children in CPS custody showing higher compliance rates. Patients with complex injuries required extended multidisciplinary care beyond one year, highlighting the need for coordinated long-term management protocols.
- 88% of child physical abuse victims complied with recommended follow-up visits in the first year post-discharge.
- Children with complex injuries from abuse required significantly longer care duration (58% still in care at 1 year vs 14%).
- Patients discharged to CPS custody showed higher follow-up compliance (90% vs 82%) compared to other discharge dispositions.
- 95% of CPA patients required multi-specialty follow-up, highlighting need for coordinated care management systems.
- Current CPA guidelines lack mechanisms for long-term resource allocation and multi-consultant coordination post-discharge.
Written by the GCMD Library team from the infographic.
A teal-colored infographic divided into sections with white text boxes, diverse child avatars at top center, a pie chart showing ICU admissions, and statistical callouts highlighted in yellow and white boxes. Icons and institutional logos appear at bottom right.
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 .