A closer look at non-accidental trauma: Caregiver assault compared to non-caregiver assault

Abstract

Purpose: The purpose of this study was to examine the outcomes of non-accidental trauma (NAT) patients compared to other trauma (OT) patients across the state of Florida. In addition, NAT and OT patients with a mechanism of injury of assault were further analyzed.

Methods: A statewide database was reviewed from January 2010 to December 2014 for patients aged 0-18years who presented following trauma. Patients were sorted by admitting diagnosis into two groups: rule out NAT and all other diagnoses. Patients with a mechanism of assault were subanalyzed and outcomes were compared.

Results: There were 46,557 patients included. NAT patients were younger, had more severe injuries and had a higher mortality rate compared to OT patients. Assault was the mechanism of injury in 95% of NAT patients. NAT assault patients were younger, required more intensive care unit (ICU) resources, and had a higher mortality rate compared to other assault patients.

Conclusion: Non-accidental trauma patients require more resources and have a higher mortality rate compared to accidental trauma patients, and these differences remain even when controlling for the mechanism of injury.

Level of evidence: III.

Keywords: Accidental trauma; Assault; Child abuse; Non-accidental trauma; Pediatric.