[Child abuse in the Emergency department: Epidemiology, management, and follow-up]

Abstract

Objective: To describe the clinical and epidemiological features, management, and follow-up of child abuse suspicions diagnosed in the Paediatric Emergency Unit.

Methods: A single-centre, observational and retrospective study was conducted between 2008 and 2017. Clinical, epidemiological and follow-up data were collected in those patients younger than 16 that were reported as child abuse suspicions. A descriptive and analytic study was performed, as well as a bivariate and multivariate analysis.

Results: A total of 404 out of 570,648 emergency patients (0.07%) were diagnosed with potential abuse. Physical abuse was the most frequent kind of abuse (40.3%). The median age was 4.3 years (IQR 1.6-10.2), and 55% were girls, with sexual abuse being more common in them (OR 3.71; 95% CI: 2.23-6.17), and physical abuse more frequent in boys (OR 1.72; 95% CI: 1.15-2.57). A total of 89 patients (22%) required admission. Age and type of abuse were independently associated with risk of admission. More than half (56%) of the cases required additional follow-up, with sexual (OR 3.98; 95% CI: 1.93-7.03) and emotional abuse (OR 4.93; 95% CI: 1.82-13.35) requiring more mental health follow-up, and physical abuse requiring more social services follow-up (OR 4.39; 95% CI: 1.61-11.98).

Conclusions: In our study, child abuse is more frequent in pre-school children. Age and type of abuse are associated with the need of admission. The kind of follow-up is determined by the type of abuse.

Keywords: Abuso sexual; Child abuse; Maltrato infantil; Paediatric emergency medicine; Servicios sociales; Sexual abuse; Social welfare; Urgencias pediátricas.