73 THE ROLE OF NON-ACCIDENTAL INJURY AND SOCIAL DEPRIVATION IN MAJOR PAEDIATRIC TRAUMA
Jennifer Billington, Joe Davidson, Erica Makin
king's college hospital, London, United Kingdom

Abstract

Aim:

The Trauma and Audit Research Network (TARN) has highlighted non-accidental injury (NAI) as a recognised cause of Paediatric Trauma. ~10% of children with trauma can be attributable to NAI. Our aim was to document institutional experience of the influence of social deprivation and involvement of safeguarding services. 

Methods:

  • Retrospective review TARN database 01/04/2016-31/03/2017.
  • Data collected:demographics, Injury Severity Score(ISS), mechanism, safeguarding and 30-day survival.
  • Postcodes cross-referenced with 2015 Index of Multiple Deprivation (IMD) to give a score and accompanying quintile.
  • Data are displayed as median(range), non-parametric tests were used with a significance level p<0.05. Logistic regression models used to examine the influence of age, gender and social deprivation.

Results:

91 patients identified, 63(69%) male. Median age 10 years (1m-15.9y). Median ISS score 16 (4-54). ISS was not correlated with age or gender. Complete data were available for 89(98%).(Table 1)

Patients in the higher quintiles of social deprivation were over-represented in the series-56% in 4th & 5th quintiles. (Chi2 p=<0.0001). 33(37%) patients had safeguarding concerns relating to their mechanism of injury, 5(6%) had NAI attributed as a direct cause. 3(3%) patients died, 2 from NAI:traumatic brain injury, 1 drowning.

Conclusions:

Our experience shows NAI-related injuries are responsible for the most serious injuries, in the youngest patients. Patients with confirmed NAI were observed to trend towards a higher deprivation index. Patients from a more deprived background are over represented among trauma patients and appear to be more likely to initiate safeguarding concerns.

 

Table 1:Patients Demographics

 

No safeguarding n=66

Safeguarding  n=28

NAI n=5

P-value

Age

9.7y(0.1-15.9)

13.6y(0.1-15.9)

0.2y(0.1-5.5)

0.005

Female:Male

17:39(0.44)

9:19(0.47)

2:3

NS(0.93)

ISS

IMD

16(5-54)

25.36(4.95-54.21)

9(4-30)

33.35(6.94-72.81)

26(17-35)

37.62(12.93- 42.78)

0.023

NS(0.21)

 


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