Child Abuse Pediatrics Research Network: The CAPNET Core Data Project

Authors

Joanne N Wood
Kristine A Campbell
James D Anderst
Angela N Bachim
Rachel P Berger
Kent P Hymel
Nancy S Harper
Megan M Letson
John D Melville
Oluwatimilehin Okunowo
Daniel M Lindberg

Publication Date

3-1-2023

Journal

Academic Pediatrics

DOI

10.1016/j.acap.2022.07.001

PMID

35840086

PMCID

PMC9834430

PubMedCentral® Posted Date

3-1-2024

PubMedCentral® Full Text Version

Author MSS

Published Open-Access

yes

Keywords

Infant, Child, Humans, Male, Child, Preschool, Female, Cross-Sectional Studies, Child Abuse, Fractures, Bone, Contusions, Referral and Consultation, child physical abuse, child abuse pediatrics, research network

Abstract

OBJECTIVE: Examine the epidemiology of subspecialty physical abuse evaluations within CAPNET, a multicenter child abuse pediatrics research network.

METHODS: We conducted a cross-sectional study of children(in-person or remote) by a child abuse pediatrician (CAP) due to concerns for physical abuse at ten CAPNET hospital systems from February 2021 through December 2021.

RESULTS: Among 3667 patients with 3721 encounters, 69.4% wereold; 44.3%old, 59.1% male; 27.1% Black; 57.8% White, 17.0% Hispanic; and 71.0 % had public insurance. The highest level of care was outpatient/emergency department in 60.7%, inpatient unit in 28.0% and intensive care in 11.4%. CAPs performed 79.1% in-person consultations and 20.9% remote consultations. Overall, the most frequent injuries were bruises (35.2%), fractures (29.0%), and traumatic brain injuries (TBI) (16.2%). Abdominal (1.2%) and spine injuries (1.6%) were uncommon. TBI was diagnosed in 30.6% of infants but only 8.4% of 1-year old children. In 68.2% of cases a report to child protective services (CPS) was made prior to CAP consultation; in 12.4% a report was made after CAP consultation. CAPs reported no concern for abuse in 43.0% of cases and mild/intermediate concern in 22.3%. Only 14.2% were categorized as definite abuse.

CONCLUSION: Most children in CAPNET werebruises, fractures, or intracranial injuries. CPS reports were frequently made prior to CAP consultation. CAPs had a low level of concern for abuse in majority of cases.