The influence of the inpatient unit on referral for relevant examinations in child abuse - 10/04/25

Doi : 10.1016/j.arcped.2025.02.003

Florian Manoeuvrier ^a, Pierre Tourneux ^a,^b,^c, Anne-Gaelle Le Moing ^c, Richard Gouron ^d, Cécile Manaouil ^e, Céline Klein ^d,^⁎
^a Pediatric Intensive Care Unit, Amiens University Hospital, Amiens, France
^b PériTox Laboratory UMR_I 01, UFR de Medicine, University of Picardie Jules Verne, Amiens, France
^c Department of Pediatric Neurology, University of Picardie Jules Verne and Amiens Picardie University Medical Center, Amiens, France
^d Department of Pediatric Orthopedics, University of Picardie Jules Verne and Amiens Picardie University Medical Center, Amiens, France
^e Department of Forensic medicine, University of Picardie Jules Verne and Amiens Picardie University Medical Center, Amiens, France

^⁎Corresponding author at: Service d'Orthopédie Pédiatrique, CHU Amiens-Picardie, 1 rue du Professeur Cabrol, F-80054 Amiens cedex 1, France.Service d'Orthopédie Pédiatrique, CHU Amiens-Picardie1 rue du Professeur Cabrol, F-80054 Amiens cedex 1France

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Abstract

Background

Physical abuse affects 4–20 % of children per year. There is a lack of knowledge and skills about child abuse among doctors, which can lead to a failure to report the child abuse situation to the authorities.

Objective

The objective of this study was to evaluate the influence of the inpatient unit on whether imaging examinations and social assessments are performed.

Method

A retrospective cohort study was carried out of children under 3 years old suspected of suffering child abuse. Demographic, clinical, and examination data were collected. In univariate analysis, we evaluated the relationship between the experience of the inpatient unit and the realization or not of imaging examinations and social assessments.

Results

Inpatient units not experienced in the management of child abuse situations were associated with a significantly increased risk of not performing cerebral magnetic resonance imaging (OR: 10.0; 95 % CI [3.8–26.3]), skeletal survey (OR: 19.0; 95 %CI [6.0–60.6]), bone scintigraphy (OR: 24.6; 95 % CI [8.5–70.8]), and fundus (OR: 13.6; 95 % CI [5.1–35.8]) examinations.