Child Abuse Research Today is a free monthly online journal that collates and summarizes the latest research about Child Abuse, including details on family violence, examinations, long-term effects, psychiatrics disorders. | ||||||||
|
Disparities in child abuse mortality are not explained by injury severity.Falcone RA, Brown RL, Garcia VF Division of Pediatric and Thoracic Surgery, Cincinnati Children's Hospital Medical Center, Cincinnati, OH 45229-3039, USA. richard.falcone@cchmc.org BACKGROUND: Unadjusted abuse-related mortality has been demonstrated to be nearly 4-fold higher for African American (AA) children. Little is known about the etiology of this disparity. This study examines the importance of injury severity and initial presentation in explaining the observed disparity. METHOD: Our trauma database was reviewed to identify all abused patients admitted over a 10-year period. Outcomes among white and AA children were compared with specific attention to injury severity scores and initial presentation. Logistic regression and Cox proportional hazard analyses were performed to evaluate the impact of race on outcome. RESULTS: There were 443 abused children identified. Thirty-eight percent of the group was AA. The overall mortality was 7.7%; however, the AA mortality was significantly higher than white children (14.8% vs 3.3%; P < .05). After controlling for injury severity and physiology at presentation, the odds ratio of mortality for an AA child was 9.14 (95% confidence interval, 1.97-42.43). Survival analysis confirmed the disparity after revealing a hazard ratio of dying for AA children of 6.51 (95% confidence interval, 2.74-15.47) compared with white children. CONCLUSION: Despite attempts to control for the clinical presentation and injury severity of abused children, significant differences in mortality persist between AA and white children. Published 11 June 2007 in J Pediatr Surg, 42(6): 1031-6; discussion 1036-7.
© 2005-2008 Child Abuse Research Today. All Rights Reserved. |
| ||||||
