Child maltreatment by non-accidental burns: interest of an algorithm of detection based on hospital discharge database
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ORIGINAL ARTICLE
Child maltreatment by non-accidental burns: interest of an algorithm of detection based on hospital discharge database Coralie Hermetet 1,2,3 & Émeline Laurent 1,2 & Yasmine El Allali 4 & Christophe Gaborit 1 & Annie Urvois-Grange 5 & Mélanie Biotteau 1,6 & Anne Le Touze 7 & Leslie Grammatico-Guillon 1,8 Received: 5 June 2020 / Accepted: 21 August 2020 # Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Objectives To build a detection algorithm of non-accidental pediatric burns (NAB) using hospital resumes from the French Hospital Discharge Database (HDD) and to describe cases with no judicial or administrative report. Materials and methods Children aged 0–16 years old hospitalized at the University Hospital of Tours from 2012 to 2017 with a coded burn were included. “Probable” or “possible” HDD cases of NAB were defined based on the International Classification of Diseases 10th version codes during the inclusion stay or the previous year. A chart review was performed on all the HDD cases and HDD non cases matched on sex and age with a 1:2 ratio. Performance parameters were estimated for three clinical definitions of child maltreatment: excluding neglect, including neglect in a restrictive definition, and in a broad definition. For clinical cases, report to the judicial or administrative authorities was searched. Results Among the 253 included children, 83 “probable” cases and 153 non-cases were analyzed. Sensitivity varied from 48 (95%CI [36–60], excluding neglect) to 90% [55–100] and specificity from 70 [63;77] to 68% [61;74]. The proportion of clinical cases with no report without justification varied from 0 (excluding neglect) to > 85% (with the broadest definition); all corresponded to possible isolated neglect. Conclusion The performances of the algorithm varied tremendously according to the clinical definition of child maltreatment. Neglect is obviously complex and tough to clinically detect. Training for healthcare professionals and qualitative studies on obstacles to report should be added to this work. Keywords Child maltreatment . Child abuse . Burns . Non-accidental burns . Screening . Hospital discharge database
Electronic supplementary material The online version of this article (https://doi.org/10.1007/s00414-020-02404-y) contains supplementary material, which is available to authorized users. * Coralie Hermetet [email protected] Émeline Laurent [email protected] Yasmine El Allali [email protected] Christophe Gaborit [email protected]
Annie Urvois-Grange [email protected] Mélanie Biotteau [email protected] Anne Le Touze [email protected] Leslie Grammatico-Guillon [email protected] Extended author information available on the last page of the article
Int J Legal Med
Introduction Context Child maltreatment has severe consequences on physical and mental development [1–4]. According to the definition of the American Centers for Disease Control and Prevention (CDC), child maltreatment re
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