Epidemiologic Trends of Domestic Violence-related Ocular Injuries Among Pediatric Patients: Data from the Nationwide Emergency Department Sample 2008-2017

Overview

Journal J AAPOS

Specialty Pediatrics

Date 2023 Nov 6

PMID 37931837

Authors

Joana E Andoh

Sofia Miguez

Sarah E Andoh

Sumarth Mehta

Tahreem A Mir

Evan M Chen

Srimathy Jain

Christopher C Teng

Kristen Nwanyanwu

Affiliations

Soon will be listed here.

Abstract

Purpose: To study the epidemiology of all domestic violence (DV)-related ocular injuries among pediatric emergency department (ED) patients in the United States.

Methods: This is a retrospective, cross-sectional study of isolated children (<18 years of age) with a diagnosis of DV and primary or secondary diagnosis of ocular injuries in the Nationwide Emergency Department Sample, 2008-2017. We calculated annual incidence of DV-related ocular injuries and prevalence by demographic variables, including age, sex, and income quartile. Median charges, median length of inpatient hospital stay, and factors associated with hospitalization were also measured.

Results: From 2008 to 2017, there were 4,125 ED encounters, with an average incidence of 0.56 per 100,000 population (males, 50.0%; mean age [SE], 9.2 [0.3]). Patients in the lowest income quartile (42.6%) and with Medicaid insurance (63.2%) were the most prevalent. The most common known perpetrator was a family member (29.4%). Most ED encounters took place at southern regional (28.6%), metropolitan teaching (67.1%) and designated trauma hospitals (57.8%). Contusion of the eye/adnexa and being struck by or against an object were the most common ocular diagnosis and known mechanism of injury, respectively. An estimated 12.4% of patients were admitted with a median hospital stay of 4 (IQR, 2-6). Median charges during the study period were $27,415.10 (IQR, $13,142.70-$54,454.90).

Conclusions: DV-related ocular injuries were most prevalent among patients with a low socioeconomic status. Given the historical underreporting of DV, future studies are warranted to identify more specific social determinants of health that contribute to such presentations.

References

Matsa E, Shi J, Wheeler K, McCarthy T, McGregor M, Leonard J . Trends in US Emergency Department Visits for Pediatric Acute Ocular Injury. JAMA Ophthalmol. 2018; 136(8):895-903. PMC: 6142941. DOI: 10.1001/jamaophthalmol.2018.2062. View

Peterson K, Huisingh C, Girkin C, Owsley C, Rhodes L . Patient satisfaction with care in an urban tertiary referral academic glaucoma clinic in the US. Patient Prefer Adherence. 2018; 12:775-781. PMC: 5953314. DOI: 10.2147/PPA.S162439. View

Devries K, Knight L, Petzold M, Merrill K, Maxwell L, Williams A . Who perpetrates violence against children? A systematic analysis of age-specific and sex-specific data. BMJ Paediatr Open. 2018; 2(1):e000180. PMC: 5842994. DOI: 10.1136/bmjpo-2017-000180. View

Meng X, DArcy C . Gender moderates the relationship between childhood abuse and internalizing and substance use disorders later in life: a cross-sectional analysis. BMC Psychiatry. 2016; 16(1):401. PMC: 5111209. DOI: 10.1186/s12888-016-1071-7. View

WEISS H, Ismailov R, Lawrence B, Miller T . Incomplete and biased perpetrator coding among hospitalized assaults for women in the United States. Inj Prev. 2004; 10(2):119-21. PMC: 1730069. DOI: 10.1136/ip.2003.004382. View

Fong K . Neighborhood inequality in the prevalence of reported and substantiated child maltreatment. Child Abuse Negl. 2019; 90:13-21. DOI: 10.1016/j.chiabu.2019.01.014. View

Monnat S, Chandler R . Long Term Physical Health Consequences of Adverse Childhood Experiences. Sociol Q. 2015; 56(4):723-752. PMC: 4617302. DOI: 10.1111/tsq.12107. View

Uppuluri S, Uppuluri A, Zarbin M, Bhagat N . Epidemiology of Pediatric Open Globe Injury in the United States. J Pediatr Ophthalmol Strabismus. 2021; 58(4):232-239. DOI: 10.3928/01913913-20210224-01. View

Kim H, Drake B . Child maltreatment risk as a function of poverty and race/ethnicity in the USA. Int J Epidemiol. 2018; 47(3):780-787. DOI: 10.1093/ije/dyx280. View

10.

Syed S, Ashwick R, Schlosser M, Gonzalez-Izquierdo A, Li L, Gilbert R . Predictive value of indicators for identifying child maltreatment and intimate partner violence in coded electronic health records: a systematic review and meta-analysis. Arch Dis Child. 2020; 106(1):44-53. PMC: 7788194. DOI: 10.1136/archdischild-2020-319027. View

11.

Yip H, Crock C, Chan E . Diagnostic error in an ophthalmic emergency department. Diagnosis (Berl). 2019; 7(2):129-131. DOI: 10.1515/dx-2019-0047. View

12.

Christian C, Scribano P, Seidl T . Pediatric injury resulting from family violence. Pediatrics. 1997; 99(2):E8. DOI: 10.1542/peds.99.2.e8. View

13.

Gilliland M, Luckenbach M, Chenier T . Systemic and ocular findings in 169 prospectively studied child deaths: retinal hemorrhages usually mean child abuse. Forensic Sci Int. 1994; 68(2):117-32. DOI: 10.1016/0379-0738(94)90309-3. View

14.

Abbott J, Shah P . The epidemiology and etiology of pediatric ocular trauma. Surv Ophthalmol. 2013; 58(5):476-85. DOI: 10.1016/j.survophthal.2012.10.007. View

15.

Webster S, OToole R, OToole A, Lucal B . Overreporting and underreporting of child abuse: teachers' use of professional discretion. Child Abuse Negl. 2005; 29(11):1281-96. DOI: 10.1016/j.chiabu.2004.02.007. View

16.

Kovler M, Ziegfeld S, Ryan L, Goldstein M, Gardner R, Garcia A . Increased proportion of physical child abuse injuries at a level I pediatric trauma center during the Covid-19 pandemic. Child Abuse Negl. 2020; 116(Pt 2):104756. PMC: 7518108. DOI: 10.1016/j.chiabu.2020.104756. View

17.

Osofsky J . Prevalence of children's exposure to domestic violence and child maltreatment: implications for prevention and intervention. Clin Child Fam Psychol Rev. 2003; 6(3):161-70. DOI: 10.1023/a:1024958332093. View

18.

Hussey J, Chang J, Kotch J . Child maltreatment in the United States: prevalence, risk factors, and adolescent health consequences. Pediatrics. 2006; 118(3):933-42. DOI: 10.1542/peds.2005-2452. View

19.

Btoush R, Campbell J, Gebbie K . Visits coded as intimate partner violence in emergency departments: characteristics of the individuals and the system as reported in a national survey of emergency departments. J Emerg Nurs. 2008; 34(5):419-27. DOI: 10.1016/j.jen.2007.10.015. View

20.

Hunter A, Flores G . Social determinants of health and child maltreatment: a systematic review. Pediatr Res. 2020; 89(2):269-274. DOI: 10.1038/s41390-020-01175-x. View