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Readmission and reinjury patterns in pediatric assault victims

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Abstract

Introduction

Repeated pediatric assault should be a never event. The purpose of this study was to evaluate the readmission and reinjury patterns in pediatric victims of assault including readmissions to different hospitals across the US.

Methods

The 2010–2014 Nationwide Readmissions Database was queried for all nonelective admissions for patients under the age of 18 years. Primary outcomes were readmission or reinjury within 1 year. Results were weighted for national estimates.

Results

Assault-related injury occurred in 46,294 pediatric patients with 11.4% of patients being readmitted within 1 year. Of those readmitted, 35.2% presented to a different hospital. Reinjury within 1 year occurred in about 1% of patients, with 14.8% of those presenting to a different hospital. Age < 13 years, firearm-injury, ISS > 15, female gender, and leaving AMA were found to be independent prognostic indicators of readmission within 1 year among pediatric assault patients.

Conclusion

Care of children who are admitted and discharged for assault injuries is more fragmented that previously thought. Quality metrics fail to capture this previously hidden population. Our results identify treatable factors which could improve the care of children after assault.

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References

  1. Ballesteros MF, Williams DD, Mack KA, Simon TR, Sleet DA (2018) The epidemiology of unintentional and violence-related injury morbidity and mortality among children and adolescents in the United States. Int J Environ Res Public Health 15(4):616

    Article  Google Scholar 

  2. Ballard ED, Kalb LG, Vasa RA, Goldstein M, Wilcox HC (2015) Self-harm, assault, and undetermined intent injuries among pediatric emergency department visits. Pediatr Emerg Care 31(12):813–818

    Article  Google Scholar 

  3. Corso PS, Mercy JA, Simon TR, Finkelstein EA, Miller TR (2007) Medical costs and productivity losses due to interpersonal and self-directed violence in the United States. Am J Prev Med 32(6):474–482

    Article  Google Scholar 

  4. Gallagher CA (2005) Injury recurrence among untreated and medically treated victims of violence in the USA. Soc Sci Med. 60(3):627–635

    Article  Google Scholar 

  5. Buicko JL, Parreco J, Willobee BA, Wagenaar AE, Sola JE (2017) Risk factors for nonelective 30-day readmission in pediatric assault victims. J Pediatr Surg 52(10):1628–1632

    Article  Google Scholar 

  6. Rivara FP, Koepsell TD, Jurkovich GJ, Gurney JG, Soderberg R (1993) The effects of alcohol abuse on readmission for trauma. JAMA 270(16):1962–1964

    Article  CAS  Google Scholar 

  7. Kaufman E, Rising K, Wiebe DJ, Ebler DJ, Crandall ML, Delgado MK (2016) Recurrent violent injury: magnitude, risk factors, and opportunities for intervention from a statewide analysis. Am J Emerg Med 34(9):1823–1830

    Article  Google Scholar 

  8. Hedges BE, Dimsdale JE, Hoyt DB, Berry C, Leitz K (1995) Characteristics of repeat trauma patients, San Diego County. Am J Public Health 85(7):1008–1010

    Article  CAS  Google Scholar 

  9. Durkin MS, Kuhn L, Davidson LL, Laraque D, Barlow B (1996) Epidemiology and prevention of severe assault and gun injuries to children in an urban community. J Trauma 41(4):667–673

    Article  CAS  Google Scholar 

  10. Agency for Healthcare Research and Quality (2017) Introduction to the HCUP Nationwide readmissions database. https://www.hcup-us.ahrq.gov/db/nation/nrd/Introduction_NRD_2010-2015.jsp. Accessed 3 Jun 2018

  11. Greenspan AI, Coronado VG, Mackenzie EJ, Schulman J, Pierce B, Provenzano G (2006) Injury hospitalizations: using the nationwide inpatient sample. J Trauma 61(5):1234–1243

    Article  Google Scholar 

  12. Parreco J, Rattan R (2018) Machine learning models for prediction of reinjury after penetrating trauma. JAMA Surg 153(2):184–186

    Article  Google Scholar 

  13. Clark DE, Osler TM, Hahn DR (2019) ICDPIC: Stata module to provide methods for translating International Classification of Diseases (Ninth Revision) diagnosis codes into standard injury categories and/or scores. https://ideas.repec.org/c/boc/bocode/s457028.html. Accessed 12 May 2015

  14. Wheeler KK, Shi J, Xiang H, Thakkar RK, Groner JI (2018) US pediatric trauma patient unplanned 30-day readmissions. J Pediatr Surg 53(4):765–770

    Article  Google Scholar 

  15. Tsai TC, Joynt KE, Orav EJ, Gawande AA, Jha AK (2013) Variation in surgical-readmission rates and quality of hospital care. N Engl J Med 369(12):1134–1142

    Article  CAS  Google Scholar 

  16. Moore L, Stelfox HT, Turgeon AF, Nathens AB, Le Sage N, Emond M et al (2014) Rates, patterns, and determinants of unplanned readmission after traumatic injury: a multicenter cohort study. Ann Surg 259(2):374–380

    Article  Google Scholar 

  17. Khan A, Nakamura MM, Zaslavsky AM, Jang J, Berry JG, Feng JY et al (2015) Same-hospital readmission rates as a measure of pediatric quality of care. JAMA Pediatr 169(10):905–912

    Article  Google Scholar 

  18. Heinze JE, Reischl TM, Bai M, Roche JS, Morrel-Samuels S, Cunningham RM et al (2016) A comprehensive prevention approach to reducing assault offenses and assault injuries among youth. Prev Sci 17(2):167–176

    Article  Google Scholar 

  19. Bartley MK (2014) Against medical advice. J Trauma Nurs 21(6):314–318

    Article  Google Scholar 

  20. Edwards J, Markert R, Bricker D (2013) Discharge against medical advice: how often do we intervene? J Hosp Med 8(10):574–577

    Article  Google Scholar 

  21. Brittan MS, Sills MR, Fox D, Campagna EJ, Shmueli D, Feinstein JA et al (2015) Outpatient follow-up visits and readmission in medically complex children enrolled in Medicaid. J Pediatr 166(4):998–1005.e1

    Article  Google Scholar 

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Funding

This study received no funding.

The authors certify that this manuscript complies with the ethical standards and have nothing to disclose. This article does not contain any studies with human participants or animals performed by any of the authors.

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Correspondence to Rishi Rattan.

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Cortolillo, N., Moeller, E., Parreco, J. et al. Readmission and reinjury patterns in pediatric assault victims. Pediatr Surg Int 36, 191–199 (2020). https://doi.org/10.1007/s00383-019-04603-0

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