Reports of Maltreatment in a Children's Hospital: Evaluation of the Epidemiological Profile and Its Relationship with the Outcome in Fractures.

Abstract

Objective  To describe suspected/confirmed cases of child maltreatment related to fractures in a pediatric hospital in southern Brazil. Method  Study of the Information System of Notifiable Diseases notifications and the victims' medical records between January/2016 and December/2020. Variables related to the victim, the perpetrator, the type of abuse, the presence of fractures, and their anatomical location and death were evaluated. Logistic regression was performed to identify fracture-related variables, adjusted for sex and age. The results were expressed in odds ratios and their respective 95% confidence intervals. It was considered significant p  < 0.05. Results  There were 276 cases, 73 infants (26.4%), male predominance (151, 54.7%), with authorship of the mistreatment by relatives (245, 96,0%), 85 (31,5%), they presented fractures, with five deaths (1.9%). Factors related to the presence of fracture: age of the victim (less than two years old; n  = 82; or 2.48; 95% CI: 1.45 - 4.25), having more than two aggressors involved ( n  = 144; or 2.09; 95% CI: 1.16-3.75), the medium being traffic/automobile accident, ( n  = 52; or 2.65; 95% CI: 1.04-6.75), consult an orthopedist ( n  = 91; or 6.77 / 95% CI: 3.66-12.51), and the need for surgical intervention ( n  = 15; OR 36.72; 95% CI: 8.22-164.03). Conclusions  The importance of suspicion, early identification of aggression, and the correct completion of notifications for activating the system of guaranteeing rights and removal of the aggressor was emphasized.