{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,11]],"date-time":"2026-05-11T11:15:46Z","timestamp":1778498146647,"version":"3.51.4"},"reference-count":19,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"7","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":["Pediatr Emer Care"],"published-print":{"date-parts":[[2024,7]]},"abstract":"<jats:sec>\n            <jats:title>Objectives<\/jats:title>\n            <jats:p>The aims of this study were to describe chief complaints provided at emergency department triage for young children ultimately given a diagnosed with injuries concerning for physical abuse and compare chief complaints by hospital child protection team assessment (abuse most likely, accident most likely, undetermined) among children younger than 2 years who were the subject of a report to child protective services.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods<\/jats:title>\n            <jats:p>This is a retrospective review of children evaluated by the child protection team at an urban children's hospital over a 5-year period. Children younger than 2 years who were the subject of a report to child protective services for suspected physical abuse were included. Chief complaints noted in emergency department triage notes were categorized as follows: 1, medical sign or symptom; 2, accidental trauma incident; 3, identified injury; 4, concern for abuse; or 5, multiple unrelated complaints. Child protection team assessments were categorized as follows: 1, abuse most likely; 2, accident most likely; or 3, undetermined. We used descriptive statistics and tests of association (\u03c7<jats:sup>2<\/jats:sup>, Fisher exact, Kruskal-Wallis).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>Median age of the 422 children included was 4.9 months. Child protection team assessment was abuse most likely in 44%, accident most likely in 23%, and undetermined in 34%. Chief complaints in the overall sample were 39% medical, 29% trauma incident, 16% injury, 10% abuse concern, and 6% multiple unrelated. When the abuse most likely and accident most likely groups were compared, medical chief complaints were more common in the former (47% vs 19%, <jats:italic toggle=\"yes\">P<\/jats:italic> &lt; 0.001), whereas trauma incident chief complaints were more common in the latter (19% vs 64%, <jats:italic toggle=\"yes\">P<\/jats:italic> &lt; 0.001). Most common medical complaints in the abuse most likely group were altered mental status, abnormal limb use, swelling, pain, apnea, and vomiting.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusion<\/jats:title>\n            <jats:p>Many children found to have injuries concerning for abuse (47%) present without mention of trauma, injury, or abuse concern as part of the chief complaint. Our findings suggest important topics to include in training physicians about recognition of abuse.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1097\/pec.0000000000003191","type":"journal-article","created":{"date-parts":[[2024,5,7]],"date-time":"2024-05-07T19:05:04Z","timestamp":1715108704000},"page":"527-531","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":1,"title":["Emergency Department Triage Chief Complaints Among Children Evaluated for Physical Abuse Concerns"],"prefix":"10.1097","volume":"40","author":[{"given":"Kristine","family":"Fortin","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joanne N.","family":"Wood","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sean M.","family":"Udell","sequence":"additional","affiliation":[{"name":"Intermountain Healthcare, Park City, Utah."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cindy W.","family":"Christian","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","published-online":{"date-parts":[[2024,5,2]]},"reference":[{"key":"bib3-20250504","doi-asserted-by":"crossref","first-page":"621","DOI":"10.1001\/jama.281.7.621","article-title":"Analysis of missed cases of abusive head trauma","volume":"281","year":"1999","journal-title":"JAMA"},{"key":"bib4-20250504","doi-asserted-by":"crossref","first-page":"36","DOI":"10.1016\/j.chiabu.2016.09.001","article-title":"Prior opportunities to identify abuse in children with abusive head trauma","volume":"60","year":"2016","journal-title":"Child Abuse Negl"},{"key":"bib5-20250504","doi-asserted-by":"crossref","first-page":"771","DOI":"10.1097\/PEC.0000000000000257","article-title":"Missed opportunities to diagnose child physical abuse","volume":"30","year":"2014","journal-title":"Pediatr Emerg 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