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13-04-2024 | Child Abuse | RESEARCH

A silent scream in the pediatric emergency department: child abuse and neglect

Authors: Bilge Akkaya, Cihan İnan, İpen İlknur Ünlü, Muhammed Mustafa Güneylioğlu, İlknur Bodur, Aytaç Göktuğ, Betül Öztürk, Raziye Merve Yaradılmış, Orkun Aydın, Ahmet Serkan Özcan, Ali Güngör, Nilden Tuygun

Published in: European Journal of Pediatrics

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Abstract

Child abuse and neglect includes any behavior that harms the child or hinders the child’s development. The aim of this study was to determine the demographic and clinical characteristics of patients with suspected child abuse or neglect in the pediatric emergency department. Between July 2017 and July 2022, patients admitted to our pediatric emergency department and consulted to the medical social services unit with a preliminary diagnosis of neglect and/or abuse were retrospectively scanned through the registry system. The patients were divided into five groups according to their victimization: physical, sexual, and emotional abuse; neglect; and medical child abuse (MCA)—Munchausen by proxy. A total of 371 children were included in the study. Two hundred twenty-two (59.8%) of the patients were female and the median age was 161 months [IQR (46–192)]. Then, 56.3% of the patients were in the adolescent age group. The most common admission time period was between 16.00 and 24.00 (n 163, 43.9%). Then, 24.2% of the patients were exposed to physical abuse, 8.8% to sexual abuse, 26.1% to emotional abuse, 50.4% to neglect, and 3.2% to MCA. One hundred eight (29.1%) patients were followed up as inpatients in the pediatric intensive care unit. Four of the patients (1%) had out-of-hospital cardiac arrest, and the deaths were in patients under 2 years of age.
  Conclusion: Pediatric emergency departments are one of the important units visited by child maltreatment patients. Victimized children may reflect their silent screams with various clinical presentations. Infants are at the greatest risk of suffering serious or fatal injuries. Health professionals working in the emergency department have an important role in detecting, treating, and preventing recurrence of child neglect and abuse.
What is Known:
• The pediatric emergency department is an important entry point in the health care system for children who experience maltreatment.
• It has a wide spectrum of physical, sexual, emotional abuse and neglect.
What is New:
• A high index of suspicion is required to diagnose cases of child maltreatment.
• Infants are at the greatest risk of suffering serious or fatal injuries.
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Metadata
Title
A silent scream in the pediatric emergency department: child abuse and neglect
Authors
Bilge Akkaya
Cihan İnan
İpen İlknur Ünlü
Muhammed Mustafa Güneylioğlu
İlknur Bodur
Aytaç Göktuğ
Betül Öztürk
Raziye Merve Yaradılmış
Orkun Aydın
Ahmet Serkan Özcan
Ali Güngör
Nilden Tuygun
Publication date
13-04-2024
Publisher
Springer Berlin Heidelberg
Published in
European Journal of Pediatrics
Print ISSN: 0340-6199
Electronic ISSN: 1432-1076
DOI
https://doi.org/10.1007/s00431-024-05526-2