Child maltreatment by non-accidental burns: interest of an algorithm of detection based on hospital discharge database

Hermetet, Coralie; Laurent, E.; Allali, Yasmine El; Gaborit, Christophe; Urvois-Grange, A; Biotteau, M; Touze, Anne Le; Grammatico‐Guillon, Leslie

doi:10.1007/s00414-020-02404-y

Cited by 7 publications

(3 citation statements)

References 34 publications

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“…However, validation of the algorithm showed excellent PPV (91%) for AP, which was higher than our UTI algorithm [ 10 ], and excellent PPV and sensitivity for urinary diversion (100% and 91%, respectively). Indeed, these situations rely on each physician’s assessment, leading to wide heterogeneity according to the healthcare practitioner and their specialty: a surgeon will likely not have the same judgement as an infectious disease specialist or an intensivist [ 18 , 25 , 29 ]. Eventually, regarding the relatively high fatality rate (6%), the claim data design of the study did not tag the cause of death, although the patient could have had an AP but died primarily from a cancer or diabetes mellitus complication during the stay.…”

Section: Discussionmentioning

confidence: 99%

Factors associated with urinary diversion and fatality of hospitalised acute pyelonephritis patients in France: a national cross-sectional study (FUrTIHF-2)

Grammatico-Guillon,

Laurent,

Fuhrman

et al. 2023

Epidemiol. Infect.

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Acute pyelonephritis (AP) epidemiology has been sparsely described. This study aimed to describe the evolution of AP patients hospitalised in France and identify the factors associated with urinary diversion and fatality, in a cross-sectional study over the 2014-2019 period. Adult patients hospitalised for AP were selected by algorithms of ICD-10 codes (PPV 90.1%) and urinary diversion procedure codes (PPV 100%). 527,671 AP patients were included (76.5% female: mean age 66.1, 48.0% Escherichia coli), with 5.9% of hospital deaths. In 2019, the AP incidence was 19.2/10,000, slightly increasing over the period (17.3/10,000 in 2014). 69,313 urinary diversions (13.1%) were performed (fatality rate 6.7%), mainly in males, increasing over the period (11.7% to 14.9%). Urolithiasis (OR [95% CI] =33. 1 [32.3-34.0]), sepsis (1.73 [1.69-1.77]) and a Charlson index ≥3 (1.32 [1.29-1.35]) were significantly associated with urinary diversion, whereas E. coli (0.75 [0.74-0.77]) was less likely associated. The same factors were significantly associated with fatality, plus old age and cancer (2.38 [2.32-2.45]). This nationwide study showed an increase in urolithiasis and identified, for the first time, factors associated with urinary diversion in AP along with death risk factors, which may aid urologists in clinical decision-making.

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Section: Discussionmentioning

confidence: 99%

Factors associated with urinary diversion and fatality of hospitalised acute pyelonephritis patients in France: a national cross-sectional study (FUrTIHF-2)

Grammatico-Guillon,

Laurent,

Fuhrman

et al. 2023

Epidemiol. Infect.

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“…Incorrect or imprecise coding can occur, and SSIs in orthopedics are rare and difficult to define clinically (eg, true infection, soiling, inflammation, etc); thus, the coding along with the medical chart review could be inaccurate and unreliable. 43,44 However, the expert group and the HAS conducted a specific and vast study of information and algorithm consolidation allowing decreasing its inherent risk. Accuracy of the patients' THA/TKA and of the SSI was confirmed by a review of >700 THA/TKA patient charts with SSIs.…”

Section: Discussionmentioning

confidence: 99%

A computerized indicator for surgical site infection (SSI) assessment after total hip or total knee replacement: The French ISO-ORTHO indicator

Grammatico‐Guillon

Miliani

Banaei-Bouchareb

et al. 2021

Infect. Control Hosp. Epidemiol.

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Objective: The French National Authority for Health (HAS), with a multidisciplinary working group, developed an indicator ‘ISO-ORTHO’ to assess surgical site infections (SSIs) after total hip arthroplasty or total knee arthroplasty (THA/TKA) based on the hospital discharge database. We present the ISO-ORTHO indicator designed for SSI automated detection and its relevance for quality improvement and hospital benchmarks. Methods: The algorithm is based on a combination of International Statistical Classification of Diseases, Tenth Revision (ICD-10) and procedure codes of the hospital stay. The target population was selected among adult patients who had a THA or TKA between January 1, 2017, and September 30, 2017. Patients at very high risk of SSI and/or with SSI not related to hospital care were excluded. We searched databases for SSIs up to 3 months after THA/TKA. The standardized infection ratio (SIR) of observed versus expected SSIs was calculated (logistic regression) and displayed as funnel plot with 2 and 3 standard deviations (SD) after adjustment for 13 factors known to increase SSI risk. Results: In total, 790 hospitals and 139,926 THA/TKA stays were assessed; 1,253 SSI were detected in the 473 included hospitals (incidence, 0.9%: 1.0% for THA, 0.80% for TKA). The SSI rate was significantly higher in males (1.2%), in patients with previous osteo-articular infection (4.4%), and those with cancer (2.3%), obesity, or diabetes. Most hospitals (89.9%) were within 2 SD; however, 12 hospitals were classified as outliers at more than +3 SD (1.6% of facilities), and 59 hospitals (7.9%) were outliers between +2 SD and +3 SD. Conclusion: ISO-ORTHO is a relevant indicator for automated surveillance; it can provide hospitals a metric for SSI assessment that may contribute to improving patient outcomes.

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“…Continuous medical and community education on NABs remains a cornerstone in the prevention of such events. 18,82 Comprehension of the family dynamics and psychosocial parameters (eg, poverty, substance dependence) that contribute to situations in which a child becomes a victim of physical abuse is a prerequisite for breaking the vicious cycle of child abuse. 6 Each state should foster community coalitions and build partnerships networks that support child care and prevent NABs.…”

Section: Recommendations For Prevention Of Nabsmentioning

confidence: 99%

A Systematic Review of Pediatric Nonaccidental Burns

Gasteratos,

McCarthy,

Chatziathanasiou

et al. 2023

Ann Plast Surg

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BackgroundInflicted burns on children are a particularly difficult medical and psychosocial issue. Pediatric nonaccidental burns (PNABs) are unfortunately relatively common. In our study, we aim to present the key findings on PNABs with the intention of raising awareness, improving early, and recognizing accurately by identifying red flags, developing triage tools, and establishing prevention strategies for this sensitive issue.MethodsA computerized literature search was conducted on PubMed, Google Scholar, and Cochrane for articles published until November 2020. The online screening process was performed by 3 independent reviewers with the Covidence tool against set inclusion/exclusion criteria. The protocol was reported using the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) protocol. The study was registered with the International Prospective Register of Systematic Reviews (PROSPERO).ResultsA total of 12 studies were included for analysis. Scald burns via forced immersion accounted for the majority of reported PNABs affecting both feet and hands. Complications included wound infection, sepsis, requiring systemic antibiotics, or intensive care. Abused children's parents had a history of mental illness, unemployment, substance abuse, incarceration, and/or low annual income.ConclusionsScalds via forced immersion remain the most common mechanism of PNABs. All health care professionals must remain vigilant, be able to recognize subtle signs of abuse, triage patients appropriately, report to police and/or social services, and ensure no further harm is made to the child or children. Repeated abuse with burns can lead to death. Prevention and education are the cornerstones for addressing this social phenomenon.

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Child maltreatment by non-accidental burns: interest of an algorithm of detection based on hospital discharge database

Cited by 7 publications

References 34 publications

Factors associated with urinary diversion and fatality of hospitalised acute pyelonephritis patients in France: a national cross-sectional study (FUrTIHF-2)

Factors associated with urinary diversion and fatality of hospitalised acute pyelonephritis patients in France: a national cross-sectional study (FUrTIHF-2)

A computerized indicator for surgical site infection (SSI) assessment after total hip or total knee replacement: The French ISO-ORTHO indicator

A Systematic Review of Pediatric Nonaccidental Burns

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