Trends in Incidence and Characteristics of Paediatric Patients with Non-accident Trauma in the United States

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Journal of Investigative Medicine





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Purpose of study Intentional injuries play a major role in child mortality and morbidity worldwide. There is a dearth of literature looking at trends in the incidence and outcomes of non-accidental trauma (NAT) amongst children, based on nationwide data from the United States (US). Our aim was to study the current epidemiology and socioeconomic factors associated with incidence and outcomes of NAT amongst children in the US. Methods used We used the Nationwide Inpatient Sample, a discharge database representative of all short-term, nonfederal hospitals in the United States. Paediatric patients were identified using the age cutoff of 18 years. International Classification of Diseases (ICD 9) codes for NAT were used to identify patients discharged with a primary diagnosis of NAT. Trends in the incidence and outcomes of paediatric NAT were compared for different age groups, gender, race and socioeconomic status (SES) based on quartiles (Qx) of median household income. Summary of results In 2013 to 2014 there were a total of about 2–3 million paediatric discharges per quartile. Out of these a total of 8985 had a primary diagnosis of NAT. Incidence was 109.1 per 1 00 000 discharges in the lowest SES (Q1) compared to 33.1 in Q4. This trend was consistent across all studied age groups and ethnicities. In-hospital mortality was 2.4% in Q1 compared to 0.4% in Q4. Conclusions Children from low SES households have a higher incidence of NAT and have significantly higher in-hospital mortality. This trend is consistent across all age groups and ethnicities.


Medicine and Health Sciences



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