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.
摘要:
目的描述巴西南部一家儿科医院与骨折有关的儿童虐待的可疑/确诊病例。方法研究2016年1月至2020年12月的法定疾病通知和受害者病历信息系统。与受害者相关的变量,肇事者,虐待的类型,骨折的存在,并对其解剖位置和死亡进行了评估。进行Logistic回归以确定骨折相关变量,根据性别和年龄进行调整。结果以比值比及其各自的95%置信区间表示。它被认为是显著的p<0.05。结果276例,73名婴儿(26.4%),男性占主导地位(151,54.7%),与作者的虐待亲属(245,96,0%),85(31.5%),他们表现出骨折,5人死亡(1.9%)。与骨折相关的因素:受害者的年龄(小于2岁;n=82;或2.48;95%CI:1.45-4.25),涉及两个以上的侵略者(n=144;或2.09;95%CI:1.16-3.75),媒介是交通/汽车事故,(n=52;或2.65;95%CI:1.04-6.75),咨询骨科医生(n=91;或6.77/95%CI:3.66-12.51),以及是否需要手术干预(n=15;OR36.72;95%CI:8.22-164.03)。结论怀疑的重要性,早期识别侵略,并强调正确完成激活权利保障制度和驱逐侵略者的通知。