Characteristics of Traumatically Injured Pediatric Assault Patients: A Statewide Assesment in Ohio.

Background: Assault is the most common form of intentional injury resulting in pediatric death. This large retrospective study analyzed statewide data from the Ohio Trauma Registry (87% of the state's hospitals) to describe risk factors of assault for pediatric trauma patients.

Methods: Of 16,938 pediatric trauma patients younger than 16 years in the state trauma registry, assault was identified in 758 patients. Patients with assault injuries and nonassault injuries were compared using χ2 tests. Multiple logistic regression evaluated associations between assault and mortality, adjusting for potential confounders. Results of the regression analyses are reported as odds ratios (OR) with 95% confidence intervals.

Results: Children younger than 1 year were 5 times more likely to be assaulted (OR, 5.34; 95% CI, 4.14-6.88) compared to children 14 to 15 years old, and black children had 3 times the risk compared to white children (OR, 3.36; 95% CI, 2.79-4.04). Children with government insurance were 3 times more likely to be assaulted compared to children with commercial insurance (OR, 3.00; 95% CI, 2.23-4.04). Assault victims were twice as likely arrive at the first hospital of care over 24 hours after injury (OR, 1.95; 95% CI, 1.44-2.66). Assault victims were more likely to die after adjusting for injury severity.

Conclusion: Assault victims experience delays in care and had twice the mortality rate after adjusting for injury severity. The worse outcomes for pediatric assault victims highlight the importance of accurately diagnosing and intervening.