438 Child Abuse Rates Among Genital Burn Victims Significantly Higher than in Unstratified Pediatric Burn Patients: An Aggregate Data Analysis

Abstract Introduction Pediatric burn patients that are victims of child abuse is a serious concern in our society today. Unfortunately, while existing literature describes the rates of child abuse in pediatric burn patients, no literature exists comparing the rates of child abuse in burn victims stratified by genital burns. Our objective was to analyze the literature regarding whether the rate of child abuse in genital burn patients is significantly different from unstratified pediatric burn patients. Methods Terms “genital burns” with “child abuse” were searched through PubMed, Ovid, and Embase. 10 articles from the available 221 were selected based on pertinence. Exclusion criteria involved studies that did not define number of genital burn victims or patients over 18 years old. In the studies, patients were similar in age and distribution of burn types. Data was collected & aggregated to calculate percent child abuse among pediatric burn patients, which was then compared to a recent, 35-year epidemiologic study of child abuse among unstratified pediatric burn patients with similar age (avg). Statistical analysis was performed via a Comparison on Proportions [N-1] Chi-Squared Test. Results The aggregated data showed that 153/387 pediatric genital burn patients were victims of child abuse (39.5%) while 403/5,748 unstratified pediatric burn patients were child abuse victims (7%). The analysis showed a significantly higher rate of child abuse among patients stratified by genital or perineal injury than unstratified pediatric burn patients (39.5% vs 7%, P < 0.0001). Conclusions While the rates of child abuse are low among pediatric burn patients overall, the rates are significantly higher when pediatric burn patients are stratified by genital burns from the existing literature. This review of the literature also showed that pediatric patients with genital burn injuries were more likely to have deeper burns requiring skin grafting & had trends for higher rates of complications and mortality. However, due to the limited data available in existing literature, further studies are warranted to aid in the development of more precise screening and assessment guidelines for child abuse within this specific, at-risk patient population. Applicability of Research to Practice This is a vital consideration for practicing physicians as it suggests a higher index of suspicion for child abuse, especially among this at-risk population that is already often underreported.