{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,12]],"date-time":"2026-01-12T22:55:04Z","timestamp":1768258504027,"version":"3.49.0"},"reference-count":27,"publisher":"American Academy of Pediatrics (AAP)","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2016,3,1]]},"abstract":"\n OBJECTIVE:<\/jats:title>\n Fractures occurring in hospitalized children may be an underrecognized preventable harm with implications for current and future bone health, but few data exist regarding the clinical characteristics of these pediatric patients. We describe the clinical characteristics of patients who sustained fractures during hospitalization over a 4.5-year period at a single tertiary care center.<\/jats:p>\n <\/jats:sec>\n \n METHODS:<\/jats:title>\n We retrospectively identified subjects who experienced inpatient fractures using a voluntary safety event reporting system and computer-assisted keyword search of the electronic medical record. We used the medical record to collect clinical characteristics, laboratory data, and survival status.<\/jats:p>\n <\/jats:sec>\n \n RESULTS:<\/jats:title>\n The safety event reporting system and keyword search identified 57% and 43% of subjects, respectively. Fifty-six subjects sustained 128 fractures while hospitalized, most frequently at the femur (33 fractures) and humerus (30 fractures). Twenty-seven subjects sustained multiple fractures. Common clinical characteristics included age \u22641 year (64%); preterm birth (53%); admission to an ICU (90%); immobilization (88%); and weight-for-age z score less than or equal to \u20132.0 (52%). Sixteen (29%) subjects died, and the mortality rate varied by primary diagnosis.<\/jats:p>\n <\/jats:sec>\n \n CONCLUSIONS:<\/jats:title>\n Critically ill, immobilized infants under 1 year of age and who were often born preterm sustained the majority of fractures occurring during hospitalization. A voluntary reporting system was insufficient to identify all inpatient fractures. Future studies should explore optimal fracture screening strategies and the relationship among fractures, severity of illness and mortality in hospitalized children.<\/jats:p>\n <\/jats:sec>","DOI":"10.1542\/hpeds.2015-0074","type":"journal-article","created":{"date-parts":[[2016,3,1]],"date-time":"2016-03-01T09:24:04Z","timestamp":1456824244000},"page":"143-150","source":"Crossref","is-referenced-by-count":8,"title":["Fractures Among Inpatients in a Pediatric Hospital"],"prefix":"10.1542","volume":"6","author":[{"given":"Lisa Swartz","family":"Topor","sequence":"first","affiliation":[{"name":"Divisions of Pediatric Endocrinology and"},{"name":"Warren Alpert School of Medicine of Brown University, Providence, Rhode Island;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joshua S.","family":"Borus","sequence":"additional","affiliation":[{"name":"Divisions of Adolescent Medicine,"},{"name":"Harvard Medical School, Boston, Massachusetts"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sarah","family":"Aspinwall","sequence":"additional","affiliation":[{"name":"Gastroenterology, Hepatology and Nutrition, and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Courtney L.","family":"Gilbert","sequence":"additional","affiliation":[{"name":"Endocrinology, Boston Children\u2019s Hospital, Boston, Massachusetts; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Catherine M.","family":"Gordon","sequence":"additional","affiliation":[{"name":"Divisions of Pediatric Endocrinology and"},{"name":"Warren Alpert School of Medicine of Brown University, Providence, Rhode Island;"},{"name":"Adolescent Medicine, Hasbro Children\u2019s Hospital, Providence, Rhode Island;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Susanna Y.","family":"Huh","sequence":"additional","affiliation":[{"name":"Harvard Medical School, Boston, Massachusetts"},{"name":"Gastroenterology, Hepatology and Nutrition, and"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"417","published-online":{"date-parts":[[2016,3,1]]},"reference":[{"issue":"3","key":"2021120817454398100_B1","doi-asserted-by":"crossref","first-page":"315","DOI":"10.1016\/j.metabol.2012.07.018","article-title":"Fractures in hospitalized children","volume":"62","author":"Huh","year":"2013","journal-title":"Metabolism"},{"issue":"2","key":"2021120817454398100_B2","doi-asserted-by":"crossref","first-page":"281","DOI":"10.1016\/j.jocd.2014.01.005","article-title":"Bone health in children and adolescents with chronic diseases that may affect the skeleton: the 2013 ISCD Pediatric Official Positions","volume":"17","author":"Bianchi","year":"2014","journal-title":"J Clin Densitom"},{"key":"2021120817454398100_B3","author":"Griffin","year":"2009"},{"issue":"4","key":"2021120817454398100_B4","doi-asserted-by":"crossref","first-page":"199","DOI":"10.1177\/0885066606287079","article-title":"Quality and safety in the intensive care unit","volume":"21","author":"Stockwell","year":"2006","journal-title":"J Intensive Care Med"},{"issue":"6","key":"2021120817454398100_B5","doi-asserted-by":"crossref","first-page":"1036","DOI":"10.1542\/peds.2014-2152","article-title":"A trigger tool to detect harm in pediatric inpatient settings","volume":"135","author":"Stockwell","year":"2015","journal-title":"Pediatrics"},{"issue":"4","key":"2021120817454398100_B6","doi-asserted-by":"crossref","first-page":"1332","DOI":"10.1542\/peds.2006-0565","article-title":"Adverse events in the neonatal intensive care unit: development, testing, and findings of an NICU-focused trigger tool to identify harm in North American NICUs","volume":"118","author":"Sharek","year":"2006","journal-title":"Pediatrics"},{"issue":"2","key":"2021120817454398100_B7","doi-asserted-by":"crossref","first-page":"149","DOI":"10.1016\/j.pedn.2010.12.005","article-title":"Lessons learned: use of event reporting by nurses to improve patient safety and quality","volume":"26","author":"Hession-Laband","year":"2011","journal-title":"J Pediatr Nurs"},{"issue":"2","key":"2021120817454398100_B8","doi-asserted-by":"crossref","first-page":"124","DOI":"10.1136\/jamia.2009.000893","article-title":"Serving the enterprise and beyond with informatics for integrating biology and the bedside (i2b2)","volume":"17","author":"Murphy","year":"2010","journal-title":"J Am Med Inform Assoc"},{"issue":"2","key":"2021120817454398100_B9","doi-asserted-by":"crossref","DOI":"10.1542\/peds.2009-0913","article-title":"New intrauterine growth curves based on United States data","volume":"125","author":"Olsen","year":"2010","journal-title":"Pediatrics"},{"key":"2021120817454398100_B10","unstructured":"Centers for Disease Control and Prevention, National Center for Health Statistics. 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