Mortality increases with recurrent episodes of nonaccidental trauma in children

Abstract

Mortality is significantly higher in children who experience rNAT. Therefore, it is critically important to effectively intervene with appropriate resources and follow-up after a child's initial episode of NAT to prevent a future catastrophic episode.

Child maltreatment

“…Deans et al [9] describe a mortality rate of 24.5% with recurrent nonaccidental trauma compared with 9.9% mortality in a single event of nonaccidental trauma. Abusive events escalate in severity at an alarming rate, and identification of abusive injuries at the onset may be lifesaving. ]…”

Evaluation of Child Maltreatment in the Emergency Department Setting

“…9 intervention, abuse may recur in nearly 35% to 50% of cases, and death may occur before the subsequent evaluation in nearly 25%. 10,11 The key to accurate diagnosis is a high level of clinical suspicion and a good understanding of the definitions.…”

Hallmarks of Non-accidental Trauma: A Surgeon’s Perspective

“…These physicians concluded that 4 of the 5 deaths reported in this cohort could have been prevented by proper detection and subsequent treatment. This study highlights the large number of children we may be missing in terms of child abuse detection leading to increased injury and mortality for these children [6].…”

“…This is particularly true, as catching child abuse in its earliest stages is paramount to preventing mortality. The literature shows that missed injury and multiple-incident child abuse are related to increase in mortality [6,7]. In one study, those children with multiple diagnosed episodes of child abuse had significantly higher mortality than those diagnosed only a single time (24.5 versus 9.9 % mortality, p = 0.002) [6].…”