Suboptimal care was frequent in severe child physical abuse cases and was mainly related to delayed diagnoses and ineffective secondary prevention

Author:

Blangis Flora123ORCID,Malorey David24,Gras‐Le Guen Christèle124,Vabres Nathalie5,Picherot Georges6,Ricaud Patricia4,Chalumeau Martin13,Launay Elise124ORCID

Affiliation:

1. Obstetrical, Perinatal and Pediatric Epidemiology Research Team, Centre of Research in Epidemiology and StatisticS Université Paris Cité, INSERM Paris France

2. Inserm CIC 1413 Nantes University Hospital Nantes France

3. Department of General Pediatrics and Pediatric Infectious Diseases AP‐HP, Necker‐Enfants Malades Hospital Université Paris Cité Paris France

4. Department of Pediatric Emergency Care Nantes University Hospital Nantes France

5. Unité d'Accueil des Enfants en Danger Nantes University Hospital Nantes France

6. Department of Pediatrics Nantes University Hospital Nantes France

Abstract

AbstractAimOur aim was to assess suboptimal care before a diagnosis of severe child physical abuse in western France.MethodsA confidential inquiry was carried out, based on children under 6 years of age who were hospitalised in the Nantes regional university hospital from 2016 to 2018. Two researchers retrospectively reviewed the medical records of all the children who were reported to the authorities for suspected severe child physical abuse. Two experts determined the optimality of care and identified the main categories of suboptimal care.ResultsThe median age of the 94 children included in the study was 8 months. A fifth of them had intra‐cranial injuries and a quarter had fractures. One child died and a third had severe sequelae at hospital discharge. Included children frequently (37%) received suboptimal care before the diagnosis of severe CPA and this fell into two categories: delayed diagnosis was experienced by 17% and ineffective secondary prevention by 22%.ConclusionSuboptimal care for severe child physical abuse was frequent and fell into two categories: delayed diagnosis and ineffective secondary prevention. These results can help us to design corrective actions.

Publisher

Wiley

Subject

General Medicine,Pediatrics, Perinatology and Child Health

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