Young Children Most Likely To Severe Injury and Death From Abuse

Dr. Ffion C Davies Consultant in Emergency Medicine & Paediatric Lead University Hospitals of Leicester NHS Trust Leicester Royal Infirmary Leicester UKMedicalResearch.com Interview with:
Dr. Ffion C Davies
Consultant in Emergency Medicine & Paediatric Lead
University Hospitals of Leicester NHS Trust
Leicester Royal Infirmary
Leicester UK

Medical Research: What is the background for this study?

Dr. Davies: This study is from the Trauma Audit Research Network data, which is a major trauma database receiving data from nearly all hospitals in England and Wales. A 2012 TARN report on major trauma in children showed a peak of injuries resulting from child abuse in the younger age group. In this study we analysed the database in more detail, in order to profile this peak of injuries from non-accidental injury (NAI).

Medical Research: What are the main findings?

Dr. Davies: The main findings are that severe injury and death resulting from non-accidental injury occurs nearly always in the under 5 year old age group, and 75% of cases are under 1 year old. This contrasts with reports in the media, whereby high profile deaths in children from non-accidental injury are often older children. This probably reflects reporting bias, because those children experienced a prolonged period of abuse, despite involvement of health and social services. Our study shows that very small infants are the most likely to die, or to sustain severe head injuries.

Medical Research: What should clinicians and patients take away from your report?

Dr. Davies: As a result of the government policy for Major Trauma Networks over recent years, major trauma now receives a higher profile and patients are receiving better care. Frontline healthcare staff need to be alerted that babies and infants may have “hidden” major trauma, and be quick to respond, in order to deliver specialist care and improve survival statistics for these children.

Medical Research: What recommendations do you have for future research as a result of this study?

Dr. Davies: A further study is now planned to compare the care received for children with severe injury from non-accidental injury with those sustaining accidental injuries. For example time to hospital, arrival by ambulance or car, time to CT scans and treatment on the intensive care unit. This will help us answer the question whether we need to adapt our Major Trauma protocols to ensure this group of children is identified and treated promptly.

Citation:

A profile of suspected child abuse as a subgroup of major trauma patients

Ffion C Davies, Timothy J Coats, Ross Fisher, Thomas Lawrence, Fiona E Lecky

Emerg Med J 2015;32:12 921-925 doi:10.1136/emermed-2015-205285

Dr. Ffion C Davies (2015). Young Children Most Likely To Severe Injury and Death From Abuse