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Prevalence of Non-accidental Trauma Among Children at ACS Verified Pediatric Trauma Centers
David D. Bogumil, MPH1,2, Natalie E. Demeter, MPH1, Rita V. Burke, PhD, MPH1,2, Jeffrey S. Upperman, MD1,2. 1Division of Pediatric Surgery Children's Hospital Los Angeles, Los Angeles, CA, USA, 2Keck School of Medicine University of Southern California, Los Angeles, CA, USA.

Background: Child abuse remains a national epidemic that has detrimental effects if unnoticed in the clinical setting. Specifically, non-accidental trauma (NAT) has large financial burdens resulting from immediate and long-term treatment. Clinicians with training and experience of pediatric trauma are better equipped to notice signs of NAT and have more experience reporting it. This additional training and experience can be measured using the American College of Surgeons (ACS) Pediatric Trauma Verification. It is hypothesized that ACS verified Pediatric Trauma Centers (vPTCs) have an increased prevalence of NAT due to this additional experience and training when compared to non-ACS vPTCs.

Methods: The National Trauma Data Bank, for the years 2007 to 2014, was utilized to compare the crude and injury severity score (ISS) adjusted prevalence ratios and corresponding 95% confidence intervals of NAT at ACS vPTCs relative to non-ACS vPTCs.

Results: The majority of all NAT cases were male (58.3%). The mean age of cases was 2.3 years old with a mean ISS of 11.1. The prevalence of NAT was 1.82 times higher among ACS vPTCs for both crude estimates [95% CI: 1.82 (1.741.90)] and after adjusting for ISS [95% CI: 1.82 (1.741.90)] (Table 1).

Conclusions: The greater prevalence of NAT at vPTCs likely represents a more accurate measure of NAT among pediatric trauma patients, likely due to more experience and training of clinicians.

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