@article{ref1,
title="Incidence of fractures attributable to abuse in young hospitalized children: results from analysis of a United States database",
journal="Pediatrics",
year="2008",
author="Leventhal, John M. and Martin, Kathleen D. and Asnes, Andrea G.",
volume="122",
number="3",
pages="599-604",
abstract="OBJECTIVE: The goal was to assess the proportion of children with fractures attributable to abuse and the incidence of fractures caused by abuse among children &lt;36 months of age who were hospitalized in the United States. METHODS: We used the Kids' Inpatient Database, which has discharge data on 80% of acute pediatric hospitalizations in the United States, for 3 time periods (1997, 2000, and 2003). Fractures attributable to abuse in children &lt;36 months of age were identified by both an International Classification of Diseases, Ninth Revision, Clinical Modification code for fracture and a diagnosis external-cause-of-injury code for abuse. Weighted estimates of the incidence were calculated. RESULTS: Among children &lt;36 months of age who were hospitalized with fractures, the proportions of cases attributable to abuse were 11.9% in 1997, 11.9% in 2000, and 12.1% in 2003. The proportions of cases attributable to abuse decreased with increasing age; for example, in 2003, the proportions attributable to abuse were 24.9% for children &lt;12 months of age, 7.2% for children 12 to 23 months of age, and 2.9% for children 24 to 35 months of age. In 2003, the incidence of fractures caused by abuse was 15.3 cases per 100000 children &lt;36 months of age. The incidence was 36.1 cases per 100000 among children &lt;12 months of age; this decreased to 4.8 cases per 100000 among 12- to 23-month-old children and 4.8 cases per 100000 among 24- to 35-month-old children. CONCLUSIONS: The Kids' Inpatient Database can be used to provide reasonable estimates of the incidence of hospitalization with fractures attributable to child abuse. For children &lt;12 months of age, the incidence was 36.1 cases per 100000, a rate similar to that of inflicted traumatic brain injury (25-32 cases per 100000).   <p>Language: en</p>",
language="en",
issn="0031-4005",
doi="10.1542/peds.2007-1959",
url="http://dx.doi.org/10.1542/peds.2007-1959"
}