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Epidemiology and clinical analysis of critical patients with child maltreatment admitted to the intensive care units

机译：重症监护病房收治的严重儿童虐待患者的流行病学和临床分析

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Children with abuse who are admitted to the intensive care unit (ICU) may have high mortality and morbidity and commonly require critical care immediately. It is important to understand the epidemiology and clinical characteristics of these critical cases of child maltreatment.We retrospectively evaluated the data for 355 children with maltreatments admitted to the ICU between 2001 and 2015. Clinical factors were analyzed and compared between the abuse and the neglect groups, including age, gender, season of admission, identifying settings, injury severity score (ISS), etiologies, length of stay (LOS) in the ICU, clinical outcomes, and mortality. In addition, neurologic assessments were conducted with the Pediatric Cerebral Performance Category (PCPC) scale.The most common type of child maltreatments was neglect (n = 259), followed by physical abuse (n = 96). The mean age of the abuse group was less than that of the neglect group (P < .05). Infants accounted for the majority of the abuse group, and the most common etiology of abuse was injury of the central nervous system (CNS). In the neglect group, most were of the preschool age and the most common etiologies of abuse were injury of the CNS and musculoskeletal system (P < .001). The mortality rate in the ICU was 9.86%. The ISS was significantly associated with mortality in both the 2 groups (both P < .05), whereas the LOS in the ICU and injuries of the CNS, musculoskeletal system, and respiratory system were all associated with mortality in the neglect group (all P < .05). The PCPC scale showed poor prognosis in the abuse group as compared to the neglect group (P < .01).In the ICU, children in the abuse group had younger age, higher ISS, and worse neurologic outcome than those in the neglect group. The ISS was a predictor for mortality in the abuse and neglect groups but the LOS in the ICUs, injuries of the CNS, musculoskeletal system, and respiratory system were indicators for mortality in the neglect group. Most importantly, identifying the epidemiological information may provide further strategies to reduce the harm, lower the medical costs, and improve clinical care quality and outcomes in children with abuse.
机译：被送入重症监护室（ICU）的受虐待儿童可能具有很高的死亡率和发病率，通常需要立即接受重症监护。了解这些儿童虐待的关键病例的流行病学和临床特征非常重要。我们回顾性评估了2001年至2015年间355例接受ICU虐待的儿童的数据。分析并比较了虐待和忽视群体的临床因素，包括年龄，性别，入院季节，识别设置，损伤严重程度评分（ISS），病因，ICU的住院时间（LOS），临床结局和死亡率。此外，神经病学评估以小儿脑性能分类（PCPC）量表进行，最常见的儿童虐待类型是忽视（n = 259），其次是身体虐待（n = 96）。虐待组的平均年龄小于被忽视组的平均年龄（P <0.05）。婴儿占虐待人群的大多数，最常见的虐待病因是中枢神经系统（CNS）的损伤。在被忽视的人群中，大多数处于学龄前，最常见的虐待病因是中枢神经系统和肌肉骨骼系统的损伤（P <0.001）。重症监护病房的死亡率为9.86％。两组的ISS均与死亡率显着相关（均P <.05），而ICU中的LOS和中枢神经系统，肌肉骨骼系统和呼吸系统的损伤均与忽视组的死亡率相关（所有P <.05）。与忽视组相比，虐待组的PCPC量表显示预后较差（P <.01）。在ICU中，虐待组的儿童比忽视组的儿童年龄小，ISS高，神经系统预后差。 ISS是虐待和忽视组死亡率的预测指标，但ICU中的LOS，CNS的损伤，肌肉骨骼系统和呼吸系统是忽视组死亡率的指标。最重要的是，识别流行病学信息可能会提供进一步的策略，以减少虐待儿童的伤害，降低医疗费用，提高临床护理质量和结果。

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