Segregating Suspected Child Maltreatment from Non-Child Maltreatment Injuries: A Population-Based Case-Control Study in Taiwan
Abstract
:1. Introduction
2. Materials and Methods
2.1. Data Source
2.2. Subjects
2.3. Variable Definitions
2.4. Statistical Analysis
3. Results
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Variables | Children with Child Abuse | Controls | p Value | ||
---|---|---|---|---|---|
n | % | n | % | ||
Total | 1525 | 20.00 | 6100 | 80.00 | |
Gender | 0.999 | ||||
Male | 919 | 60.26 | 3676 | 60.26 | |
Female | 606 | 39.74 | 2424 | 39.74 | |
Age (years) | 0.999 | ||||
<1 | 562 | 36.85 | 2248 | 36.85 | |
1–2 | 207 | 13.57 | 828 | 13.57 | |
3–5 | 186 | 12.20 | 744 | 12.20 | |
6–11 | 166 | 10.89 | 664 | 10.89 | |
12–18 | 404 | 26.49 | 1616 | 26.49 | |
Household income (USD) | <0.001 | ||||
Without low-income | 1446 | 94.82 | 5866 | 96.16 | |
With low-income | 79 | 5.18 | 234 | 3.84 | |
Geographic region | <0.001 | ||||
Northern | 599 | 39.28 | 2110 | 34.59 | |
Middle | 476 | 31.21 | 1974 | 32.36 | |
Southern | 392 | 25.70 | 1535 | 25.16 | |
Eastern | 56 | 3.67 | 448 | 7.34 | |
Outlets islands | 2 | 0.13 | 33 | 0.54 | |
Urbanization level | <0.001 | ||||
1 (most urbanized) | 570 | 37.38 | 1590 | 26.07 | |
2 | 688 | 45.11 | 2751 | 45.10 | |
3 | 79 | 5.18 | 603 | 9.89 | |
4 (least urbanized) | 188 | 12.33 | 1156 | 18.95 | |
Admission season | <0.001 | ||||
Spring (March–May) | 366 | 24.00 | 1685 | 27.62 | |
Summer (June–August) | 387 | 25.38 | 1444 | 23.67 | |
Autumn (September–November) | 420 | 27.54 | 1305 | 21.39 | |
Winter (December–February) | 352 | 23.08 | 1666 | 27.31 |
Injury Types | Children with Child Abuse | Controls | p Value | ||
---|---|---|---|---|---|
n | % | n | % | ||
Fracture of skull | 62 | 4.07 | 252 | 4.13 | 0.983 |
Fracture of neck and trunk | 5 | 0.33 | 49 | 0.80 | 0.908 |
Fracture of upper limb | 58 | 3.80 | 1333 | 21.85 | 0.001 |
Fracture of lower limb | 41 | 2.69 | 506 | 8.30 | 0.199 |
Dislocation | 1 | 0.07 | 77 | 1.26 | 0.971 |
Sprains and strains of joints and adjacent muscles | 2 | 0.13 | 153 | 2.51 | 0.830 |
Intracranial injury | 534 | 35.02 | 502 | 8.23 | <0.001 |
Internal injury of chest, abdomen and pelvis | 42 | 2.75 | 1846 | 30.26 | <0.001 |
Open wound of head, neck and trunk | 31 | 2.03 | 216 | 3.54 | 0.622 |
Open wound of upper limb | 9 | 0.59 | 128 | 2.10 | 0.755 |
Open wound of lower limb | 9 | 0.59 | 139 | 2.28 | 0.736 |
Injury to blood vessels | 0 | 0.00 | 8 | 0.13 | 0.594 |
Poisonings and toxic effects | 4 | 0.26 | 168 | 2.75 | 0.761 |
Superficial injury | 11 | 0.72 | 102 | 1.67 | 0.810 |
Contusion with intact skin surface | 79 | 5.18 | 114 | 1.87 | 0.201 |
Crushing injury | 4 | 0.26 | 44 | 0.72 | 0.915 |
Foreign body entering through orifice | 4 | 0.26 | 86 | 1.41 | 0.846 |
Burns | 19 | 1.25 | 237 | 3.89 | 0.557 |
Injury to nerves and spinal cord | 5 | 0.33 | 32 | 0.52 | 0.955 |
Traumatic complications | 36 | 2.36 | 55 | 0.90 | 0.573 |
Others | 569 | 37.31 | 53 | 0.87 | <0.001 |
Variables | Children with Child Abuse | Controls | p Value | ||
---|---|---|---|---|---|
n | % | n | % | ||
Total | 1525 | 20.00 | 6100 | 80.00 | |
Level of care | <0.001 | ||||
Hospital center | 723 | 47.41 | 1744 | 28.59 | |
Regional hospital | 521 | 34.16 | 3251 | 53.30 | |
Local hospital | 281 | 18.43 | 1105 | 18.11 | |
Catastrophic illness | <0.001 | ||||
Without | 1479 | 96.98 | 5991 | 98.21 | |
With | 46 | 3.02 | 109 | 1.79 | |
Charlson comorbidity index (CCI) | 0.10 ± 0.40 | 0.02 ± 0.17 | <0.001 | ||
length of hospital stays | 8.91 ± 10.96 | 4.41 ± 4.41 | <0.001 | ||
Medical cost (USD) | 2563.68 ± 4658.38 | 880.27 ± 1747.04 | <0.001 | ||
Surgical operation | <0.001 | ||||
Without | 1174 | 76.98 | 3525 | 57.79 | |
With | 351 | 23.02 | 2575 | 42.21 | |
Prognosis | <0.001 | ||||
Survive | 1435 | 94.10 | 6071 | 99.52 | |
Mortality | 90 | 5.90 | 29 | 0.48 |
Variables | Bivariate Model | Multivariate Model | ||||
---|---|---|---|---|---|---|
Crude OR | 95% CI | p Value | Adjusted OR | 95% CI | p Value | |
Low-income | 1.370 | [1.054–1.779] | 0.018 | 1.965 | [1.483–2.604] | <0.001 |
Urbanization level | ||||||
1 (most urbanized) | 2.204 | [1.839–2.643] | <0.001 | 1.560 | [1.242–1.96] | <0.001 |
2 | 1.538 | [1.201–1.832] | <0.001 | 1.285 | [0.956–1.562] | 0.072 |
3 | 0.806 | [0.608–1.067] | 0.131 | 0.767 | [0.57–1.032] | 0.080 |
4 (least urbanized) | Reference | Reference | ||||
Catastrophic illness | ||||||
Without | Reference | Reference | ||||
With | 1.708 | [1.206–2.472] | 0.003 | 1.385 | [0.922–2.079] | 0.117 |
CCI | 3.002 | [2.385–3.780] | <0.001 | 2.099 | [1.65–2.672] | <0.001 |
Level of care | ||||||
Hospital center | 1.630 | [1.393–1.904] | <0.001 | 1.025 | [0.653–1.872] | 0.351 |
Regional hospital | 0.630 | [0.537–1.047] | 0.074 | 0.701 | [0.378–1.450] | 0.154 |
Local hospital | Reference | Reference | ||||
Surgical operation | ||||||
Without | Reference | Reference | ||||
With | 0.680 | [0.364–0.912] | 0.005 | 0.761 | [0.196–1.356] | 0.297 |
Admission Season | ||||||
Spring | Reference | Reference | ||||
Summer | 1.234 | [1.052–1.447] | 0.010 | 1.279 | [0.972–1.524] | 0.067 |
Autumn | 1.482 | [1.266–1.725] | <0.001 | 1.545 | [1.296–1.84.] | <0.001 |
Winter | 0.974 | [0.828–1.143] | 0.737 | 0.928 | [0.777–1.109] | 0.413 |
Injury Types | Bivariate Model | Multivariate Model | ||||
---|---|---|---|---|---|---|
Crude OR | 95%CI | p Value | Adjusted OR | 95%CI | p Value | |
Fracture of skull | 0.256 | [0.121–1.597] | 0.982 | 0.298 | [0.121–1.597] | 0.982 |
Fracture of neck and trunk | 0.125 | [0.059–1.265] | 0.886 | 0.198 | [0.035–1.988] | 0.886 |
Fracture of upper limb | 0.449 | [0.121–0.795] | <0.001 | 0.896 | [0.772–0.995] | 0.025 |
Fracture of lower limb | 0.812 | [0.254–1.950] | 0.195 | 1.454 | [0.898–2.982] | 0.232 |
Dislocation | 0.013 | [0.002–5.454] | 0.965 | 0.124 | [0.012–4.955] | 0.772 |
Sprains and strains of joints and adjacent muscles | 0.019 | [0.003–3.454] | 0.565 | 0.059 | [0.026–3.495] | 0.542 |
Intracranial injury | 1.067 | [1.011–1.564] | <0.001 | 1.234 | [1.025–1.670] | <0.001 |
Internal injury of chest, abdomen and pelvis | 0.023 | [0.002–0.124] | <0.001 | 0.121 | [0.029–0.568] | 0.001 |
Open wound of head, neck and trunk | 0.111 | [0.029–1.590] | 0.645 | 0.098 | [0.033–1.565] | 0.644 |
Open wound of upper limb | 0.076 | [0.003–2.950] | 0.765 | 0.121 | [0.034–1.998] | 0.795 |
Open wound of lower limb | 0.065 | [0.012–1.986] | 0.798 | 0.055 | [0.011–1.749] | 0.897 |
Poisonings and toxic effects | 0.024 | [0.002–1.465] | 0.464 | 0.101 | [0.044–1.989] | 0.511 |
Superficial injury | 0.178 | [0.022–1.596] | 0.765 | 0.199 | [0.102–2.995] | 0.564 |
Contusion with intact skin surface | 0.693 | [0.465–3.454] | 0.295 | 0.795 | [0.345–3.495] | 0.265 |
Crushing injury | 0.091 | [0.002–2.986] | 0.911 | 0.895 | [0.154–2.412] | 0.881 |
Foreign body entering through orifice | 0.047 | [0.014–4.562] | 0.842 | 0.124 | [0.022–4.431] | 0.701 |
Burns | 0.081 | [0.025–1.113] | 0.541 | 0.894 | [0.131–1.234] | 0.454 |
Injury to nerves and spinal cord | 0.156 | [0.104–4.560] | 0.951 | 0.442 | [0.265–4.65] | 0.851 |
Traumatic complications | 0.656 | [0.557–2.982] | 0.575 | 1.021 | [0.598–2.988] | 0.568 |
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Jin, Y.-T.; Chen, C.-M.; Huang, Y.-C.; Chung, C.-H.; Sun, C.-A.; Huang, S.-H.; Chien, W.-C.; Wu, G.-J. Segregating Suspected Child Maltreatment from Non-Child Maltreatment Injuries: A Population-Based Case-Control Study in Taiwan. Int. J. Environ. Res. Public Health 2022, 19, 4591. https://doi.org/10.3390/ijerph19084591
Jin Y-T, Chen C-M, Huang Y-C, Chung C-H, Sun C-A, Huang S-H, Chien W-C, Wu G-J. Segregating Suspected Child Maltreatment from Non-Child Maltreatment Injuries: A Population-Based Case-Control Study in Taiwan. International Journal of Environmental Research and Public Health. 2022; 19(8):4591. https://doi.org/10.3390/ijerph19084591
Chicago/Turabian StyleJin, Yo-Ting, Chin-Mi Chen, Yao-Ching Huang, Chi-Hsiang Chung, Chien-An Sun, Shi-Hao Huang, Wu-Chien Chien, and Gwo-Jang Wu. 2022. "Segregating Suspected Child Maltreatment from Non-Child Maltreatment Injuries: A Population-Based Case-Control Study in Taiwan" International Journal of Environmental Research and Public Health 19, no. 8: 4591. https://doi.org/10.3390/ijerph19084591