High prevalence of non-accidental trauma among deceased children presenting at Level I trauma centers in the Netherlands

• DOI: 10.1007/s12024-021-00416-7
• Publication Date: 2021-11-13T00:02:58Z
• Authors: Marie-Louise H. J...; Roel Bakx; Wilma L. J. M. Du...; Francee Aarts; Ivo de Blaauw; Frank W. Bloemers; Jan A. Ten Bosch; Martina Evers; Alexander P. A. G...; Marie-Josée Hondius; Roland L. J. H. v...; Erik Huisman; Jan B. F. Hulscher; Claudia M. G. Key...; Egbert Krug; Jack Menke; Tatjana Naujocks; Udo J. L. Reijnders; Victor A. de Ridder; W. Richard Spanje...; Arianne H. Teeuw; Hilco P. Theeuwes; Will Vervoort-Ste...; Selena de Vries; Ralph de Wit; Rick R. van Rijn; ; Anne de Boer; Tina Dorn; Esther Edelenbos; J. Carel Goslings; Steven Kooiker; Irma Michielsen; Lia P. G. W. van ...; Annelies Toor; Marjo Affourtit; Jan C. van Ditshu...; Rene M. H. Wijnen; Dagmar R. J. Kempink; Gert J. H. J. M. ...; Tjebbe Hagenaars; Dennis den Hartog; M. A. C. Jansen; J. H. Allema; Floris E. P. Kanters; Annemieke Aalbers...; Saskia Beunder; Arnaud Mulder; Frans Smiers; Rina C. Hartendorf; Audrey A. A. Fidd...; Birgit Levelink; Martijn Poeze; Gisela de Heus; Vidija Soerdjbali...; Michael J. R. Edw...; Tjarda N. Tromp; Benn Beuker; Inge H. F. Reininga; Klaus Wendt; Stasja J. G. Aspers; Elise M. van de P...
• Keywords: Accidental; Child neglect

Between 0.1-3% of injured children who present at a hospital emergency department ultimately die as result their injuries. These events are typically reported unnatural causes death and may from either accidental or non-accidental trauma (NAT). Examples the latter include that is inflicted directly resulting neglect. Although consultation with forensic physician mandatory for all deceased children, prevalence fatal neglect among currently unclear.This retrospective study included (0-18 years) presented died one 11 Level I centers in Netherlands between January 1, 2014, 2019. Outcomes were classified based on conclusions Child Abuse Neglect team those pathologists and/or court cases referred legally mandated autopsies. Cases which unavailable there was no clear cause reviewed by an expert panel.The 175 childhood death. Seventeen (9.7%) these due to (9.7%), 18 (10.3%) neglect, 140 (80%) accidents. Preschool (< 5 years old) significantly more likely injuries compared older (44% versus 6%, p < 0.001, odds ratio [OR] 5.80, 95% confidence interval [CI] 2.66-12.65). Drowning accounted 14 (78%) pediatric deaths representing 8% total cases. Postmortem radiological studies autopsies performed 37 (21%) death.One every five our nationwide center attributed NAT; 44% experienced preschool-aged children. A remarkable number drownings only one-fifth The limited use postmortem investigations have resulted missed NAT, will overall underestimation NAT