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Multicenter Study
. 2023 Mar;23(2):402-409.
doi: 10.1016/j.acap.2022.07.001. Epub 2022 Jul 12.

Child Abuse Pediatrics Research Network: The CAPNET Core Data Project

Joanne N Wood  1 , Kristine A Campbell  2 , James D Anderst  3 , Angela N Bachim  4 , Rachel P Berger  5 , Kent P Hymel  6 , Nancy S Harper  7 , Megan M Letson  8 , John D Melville  9 , Oluwatimilehin Okunowo  10 , Daniel M Lindberg  11
Affiliations
Multicenter Study

Child Abuse Pediatrics Research Network: The CAPNET Core Data Project

Joanne N Wood et al. Acad Pediatr. 2023 Mar.

Abstract

Objective: Examine the epidemiology of subspecialty physical abuse evaluations within CAPNET, a multicenter child abuse pediatrics research network.

Methods: We conducted a cross-sectional study of children <10 years old who underwent an evaluation (in-person or remote) by a child abuse pediatrician (CAP) due to concerns for physical abuse at ten CAPNET hospital systems from February 2021 through December 2021.

Results: Among 3667 patients with 3721 encounters, 69.4% were <3 years old; 44.3% <1 year old, 59.1% male; 27.1% Black; 57.8% White, 17.0% Hispanic; and 71.0 % had public insurance. The highest level of care was outpatient/emergency department in 60.7%, inpatient unit in 28.0% and intensive care in 11.4%. CAPs performed 79.1% in-person consultations and 20.9% remote consultations. Overall, the most frequent injuries were bruises (35.2%), fractures (29.0%), and traumatic brain injuries (TBI) (16.2%). Abdominal (1.2%) and spine injuries (1.6%) were uncommon. TBI was diagnosed in 30.6% of infants but only 8.4% of 1-year old children. In 68.2% of cases a report to child protective services (CPS) was made prior to CAP consultation; in 12.4% a report was made after CAP consultation. CAPs reported no concern for abuse in 43.0% of cases and mild/intermediate concern in 22.3%. Only 14.2% were categorized as definite abuse.

Conclusion: Most children in CAPNET were <3 years old with bruises, fractures, or intracranial injuries. CPS reports were frequently made prior to CAP consultation. CAPs had a low level of concern for abuse in majority of cases.

Keywords: child abuse pediatrics; child physical abuse; research network.

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Conflict of interest statement

Declaration of Interests: Dr. Lindberg has provided paid expert witness testimony in cases with concern for child physical abuse. Drs. Berger’s, Campbell’s, Letson’s, Harper’s, Melville’s and Wood’s institutions have been paid in cases with concern for child physical abuse for which they have provided expert testimony. The other authors report no conflicts of interest.

Figures

Figure -1:
Figure -1:
Encounter volume by age (N=3721) *Age is in years unless otherwise specified.
See this image and copyright information in PMC

References

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