Documentation of drug abuse in the family or household of children admitted to the hospital for non-accidental trauma

• Published in: Child abuse & neglect Vol. 109; pp. 104696 - 6
• Main Authors: De Avila, Camila, Andrews, Brooke, Buckman, Cierra, Tumin, Dmitry, Ledoux, Matthew
• Format: Journal Article
• Language: English
• Published: England Elsevier Ltd 01.11.2020; Elsevier Science Ltd
• Subjects: Accidents; Case management; Child Abuse; Child abuse & neglect; Child Neglect; Children; Discharge; Documentation; Drug abuse; Drugs; Emergency services; Families & family life; Family (Sociological Unit); Hospitalization; Hospitals; Household drug abuse; Inpatient care; Non-accidental trauma; Patient admissions; Social exclusion; Substance abuse; Teams; Trauma; Non-accidental trauma; Hospitalization; Household drug abuse
• ISSN: 0145-2134; 1873-7757
• DOI: 10.1016/j.chiabu.2020.104696

Drug abuse in the family is known to increase the risk of child abuse, but its impact on outcomes of hospitalizations for non-accidental trauma (NAT) has not been characterized. We aimed to identify how frequently drug abuse in the household was documented among children with known or suspected NAT, and to correlate drug abuse in the family with hospitalization outcomes. At our tertiary care hospital, we retrospectively queried hospital admissions of children ages 0–17 who had a Child Abuse and Neglect consultation ordered during an inpatient stay. Case manager documentation and consult notes from the inpatient response team were used to determine suspected or confirmed presence of household substance abuse. We identified 185 children meeting inclusion criteria (59 % <1 year; 34 % 1−5 years; 7% 6–14 years of age). Drug abuse in the family was documented in 44 cases (24 %). Among 178 children surviving to discharge, drug abuse was associated with lower likelihood of discharge home (50 % vs. 70 % among children with no documented drug abuse, p = 0.018). After discharge, we found no statistically significant differences in rehospitalizations or emergency department visits according to documentation of drug abuse in the family. Our study addresses the role of family drug abuse in outcomes of hospitalizations for NAT. Significantly, half of cases with suspected or known drug abuse had no prior CPS involvement, and drug abuse was associated with discharge outcomes after controlling for prior CPS involvement.