Journal article
The Efficacy of Hair and Urine Toxicology Screening on the Detection of Child Abuse by Burning
Journal of burn care & research, Vol.30(4), pp.587-592
2009
DOI: 10.1097/BCR.0b013e3181abfd30
PMID: 19506505
Abstract
Abuse by burning is estimated to occur in 1 to 25% of children admitted with burn injuries annually. Hair and urine toxicology for illicit drug exposure may provide additional confirmatory evidence for abuse. To determine the impact of hair and urine toxicology on the identification of child abuse, we performed a retrospective chart review of all pediatric patients admitted to our burn unit. The medical records of 263 children aged 0 to 16 years of age who were admitted to our burn unit from January 2002 to December 2007 were reviewed. Sixty-five children had suspected abuse. Of those with suspected abuse, 33 were confirmed by the Department of Health and Human Services and comprised the study group. Each of the 33 cases was randomly matched to three pediatric (0–16 years of age) control patients (99). The average annual incidence of abuse in pediatric burn patients was 13.7 ± 8.4% of total annual pediatric admissions (range, 0–25.6%). Age younger than 5 years, hot tap water cause, bilateral, and posterior location of injury were significantly associated with nonaccidental burn injury on multivariate analysis. Thirteen (39.4%) abused children had positive ancillary tests. These included four (16%) skeletal surveys positive for fractures and 10 (45%) hair samples positive for drugs of abuse (one patient had a fracture and a positive hair screen). In three (9.1%) patients who were not initially suspected of abuse but later confirmed, positive hair test for illicit drugs was the only indicator of abuse. Nonaccidental injury can be difficult to confirm. Although inconsistent injury history and burn injury pattern remain central to the diagnosis of abuse by burning, hair and urine toxicology offers a further means to facilitate confirmation of abuse.
Details
- Title: Subtitle
- The Efficacy of Hair and Urine Toxicology Screening on the Detection of Child Abuse by Burning
- Creators
- Shady N HAYEK - Division of Plastic and Reconstructive Surgery, American University of Beirut, LebanonLucy A WIBBENMEYER - Department of Surgery, University of Iowa Carver College of Medicine, Iowa City, United StatesLyn Dee H KEALEY - Department of Social Work, University of Iowa Carver College of Medicine, Iowa City, United StatesIngrid M WILLIAMS - Department of Surgery, University of Iowa Carver College of Medicine, Iowa City, United StatesResmiye ORAL - Child Protection Program, University of Iowa Carver College of Medicine, Iowa City, United StatesObiora ONWUAMEZE - Department of Family Medicine, University of Iowa Carver College of Medicine, Iowa City, United StatesTimothy D LIGHT - Department of Surgery, University of Iowa Carver College of Medicine, Iowa City, United StatesBarbara A LATENSER - Department of Surgery, University of Iowa Carver College of Medicine, Iowa City, United StatesRobert W LEWIS - Department of Surgery, University of Iowa Carver College of Medicine, Iowa City, United StatesGerald P KEALEY - Department of Surgery, University of Iowa Carver College of Medicine, Iowa City, United States
- Resource Type
- Journal article
- Publication Details
- Journal of burn care & research, Vol.30(4), pp.587-592
- DOI
- 10.1097/BCR.0b013e3181abfd30
- PMID
- 19506505
- NLM abbreviation
- J Burn Care Res
- ISSN
- 1559-047X
- eISSN
- 1559-0488
- Publisher
- Lippincott Williams & Wilkins; Philadelphia, PA
- Language
- English
- Date published
- 2009
- Academic Unit
- Stead Family Department of Pediatrics; Surgery; Injury Prevention Research Center
- Record Identifier
- 9984051739302771
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