• Hallie J Quiroz, Joshua P Parreco, Nima Khosravani, Chad Thorson, Eduardo A Perez, Juan E Sola, Rishi Rattan, and Louis R Pizano.
• Dewitt Daughtry Family Department of Surgery, University of Miami, Miller School of Medicine, Miami, Florida.
• J. Surg. Res. 2021 Jan 1; 257: 232-238.

BackgroundThe purpose of this study was to identify the pattern of injuries that relates to abuse and neglect in children with burn injuries.MethodsThe Nationwide Readmissions Database for 2010-2014 was queried for all patients aged less than 18 y admitted with burn injuries. The primary outcome was child maltreatment identified at the index admission. The secondary outcome was readmission for maltreatment. A subgroup analysis was performed on patients without a diagnosis of maltreatment during the index admission. Multivariable logistic regression was performed for each outcome.ResultsThere were 57,939 admissions identified and 1960 (3.4%) involved maltreatment at the index admission. Maltreatment was associated with total body surface area burned >20% (odds ratio (OR) 2.79, P < 0.001) and burn of the lower limbs (OR 1.37, P < 0.001). Readmission for maltreatment was found in 120 (0.2%), and the strongest risk factor was maltreatment identified at the index admission (OR 5.11, P < 0.001). After excluding the patients with maltreatment identified at the index admission, 96 (0.17%) children were found to have a readmission for maltreatment that may have been present on the index admission and subsequently missed. The strongest risk factor was burn of the eye or ocular adnexa (OR 3.79, P = 0.001).ConclusionsThis study demonstrates that a portion of admissions for burn injuries in children could involve maltreatment that was undiagnosed. Identifying these at-risk individuals is critical to prevention efforts.Copyright © 2020 Elsevier Inc. All rights reserved.

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