{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,27]],"date-time":"2025-09-27T04:04:39Z","timestamp":1758945879922,"version":"3.40.5"},"reference-count":41,"publisher":"American Academy of Pediatrics (AAP)","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2018,2,1]]},"abstract":"<jats:sec><jats:title>OBJECTIVES:<\/jats:title><jats:p>To compare rates of previous inpatient visits among children hospitalized with child physical abuse (CPA) with controls as well as between individual abuse types.<\/jats:p><\/jats:sec><jats:sec><jats:title>METHODS:<\/jats:title><jats:p>In this study, we used the Pediatric Health Information System administrative database of 44 children\u2019s hospitals. Children &amp;lt;6 years of age hospitalized with CPA between January 1, 2011, and September 30, 2015, were identified by discharge codes and propensity matched to accidental injury controls. Rates for previous visit types were calculated per 10\u2009000 months of life. \u03c72 and Poisson regression were used to compare proportions and rates.<\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS:<\/jats:title><jats:p>There were 5425 children hospitalized for CPA. Of abuse and accident cases, 13.1% and 13.2% had a previous inpatient visit, respectively. At previous visits, abused children had higher rates of fractures (rate ratio [RR] = 3.0 times; P = .018), head injuries (RR = 3.5 times; P = .005), symptoms concerning for occult abusive head trauma (AHT) (eg, isolated vomiting, seizures, brief resolved unexplained events) (RR = 1.4 times; P = .054), and perinatal conditions (eg, prematurity) (RR = 1.3 times; P = .014) compared with controls. Head injuries and symptoms concerning for occult AHT also more frequently preceded cases of AHT compared with other types of abuse (both P &amp;lt; .001).<\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSIONS:<\/jats:title><jats:p>Infants hospitalized with perinatal-related conditions, symptoms concerning for occult AHT, and injuries are inpatient populations who may benefit from abuse prevention efforts and\/or risk assessments. Head injuries and symptoms concerning for occult AHT (eg, isolated vomiting, seizures, and brief resolved unexplained events) may represent missed opportunities to diagnose AHT in the inpatient setting; however, this requires further study.<\/jats:p><\/jats:sec>","DOI":"10.1542\/hpeds.2017-0109","type":"journal-article","created":{"date-parts":[[2018,2,1]],"date-time":"2018-02-01T09:50:26Z","timestamp":1517478626000},"page":"81-88","source":"Crossref","is-referenced-by-count":16,"title":["Potential Opportunities for Prevention or Earlier Diagnosis of Child Physical Abuse in the Inpatient Setting"],"prefix":"10.1542","volume":"8","author":[{"given":"Henry T.","family":"Puls","sequence":"first","affiliation":[{"name":"Divisions of Hospital Medicine and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"James D.","family":"Anderst","sequence":"additional","affiliation":[{"name":"Child Abuse and Neglect, Department of Pediatrics, Children\u2019s Mercy Hospital, School of Medicine, University of Missouri-Kansas City, Kansas City, Missouri;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jessica L.","family":"Bettenhausen","sequence":"additional","affiliation":[{"name":"Divisions of Hospital Medicine and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Abbey","family":"Masonbrink","sequence":"additional","affiliation":[{"name":"Divisions of Hospital Medicine and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jessica L.","family":"Markham","sequence":"additional","affiliation":[{"name":"Divisions of Hospital Medicine and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Laura","family":"Plencner","sequence":"additional","affiliation":[{"name":"Divisions of Hospital Medicine and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Molly","family":"Krager","sequence":"additional","affiliation":[{"name":"Divisions of Hospital Medicine and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matthew B.","family":"Johnson","sequence":"additional","affiliation":[{"name":"Divisions of Hospital Medicine and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jacqueline M.","family":"Walker","sequence":"additional","affiliation":[{"name":"Divisions of Hospital Medicine and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christopher S.","family":"Greeley","sequence":"additional","affiliation":[{"name":"Division of Child Abuse and Neglect, Department of Pediatrics, Baylor College of Medicine, Houston, Texas; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matthew","family":"Hall","sequence":"additional","affiliation":[{"name":"Divisions of Hospital Medicine and"},{"name":"Children\u2019s Hospital Association, Lenexa, Kansas"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"417","published-online":{"date-parts":[[2018,2,1]]},"reference":[{"issue":"6","key":"2021120817281120100_B1","doi-asserted-by":"crossref","DOI":"10.1542\/peds.2012-1464","article-title":"Trends in hospitalization rates and severity of injuries from abuse in young children, 1997-2009","volume":"131","author":"Farst","year":"2013","journal-title":"Pediatrics"},{"issue":"3","key":"2021120817281120100_B2","doi-asserted-by":"crossref","first-page":"458","DOI":"10.1542\/peds.2011-1277","article-title":"Using US data to estimate the incidence of serious physical abuse in children","volume":"129","author":"Leventhal","year":"2012","journal-title":"Pediatrics"},{"issue":"4","key":"2021120817281120100_B3","doi-asserted-by":"crossref","first-page":"637","DOI":"10.1542\/peds.2010-2185","article-title":"Abusive head trauma during a time of increased unemployment: a multicenter analysis","volume":"128","author":"Berger","year":"2011","journal-title":"Pediatrics"},{"issue":"2","key":"2021120817281120100_B4","doi-asserted-by":"crossref","DOI":"10.1542\/peds.2011-3755","article-title":"Local macroeconomic trends and hospital admissions for child abuse, 2000-2009","volume":"130","author":"Wood","year":"2012","journal-title":"Pediatrics"},{"key":"2021120817281120100_B5","unstructured":"US Department of Health & Human Services, Administration for Children and Families, Children\u2019s Bureau. 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