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Oral Presentation - 157
What We Know About Child Maltreatment in Pediatric Burn Patients – A Retrospective Single-Center Analysis from a German Burn Center
Judith Lohmann 1, Birte Mack-Detlefsen 1, Thomas Boemers 1, Sibylle Banaschak 2
1 Children's Hospital Amsterdamer Straße, Clinic for Pediatric and Adolescent Surgery and Pediatric Urology, Cologne, Germany
2 Institute of Legal Medicine, Medical Faculty, University of Cologne, Cologne, Germany
Objectives
Non-accidental injuries are a common finding in pediatric burn cases but are frequently underdiagnosed, potentially leading to prolonged exposure to harm. More frequent and often more subtle are injuries resulting from neglect, where prevention or timely treatment was lacking.
This study aimed to identify factors that may help recognize children at risk of maltreatment and to determine predictors distinguishing accidental from non-accidental injuries.
Methods
We conducted a retrospective analysis of all pediatric inpatients treated for thermal injuries at our burn center between 2018 and 2023. Each case was reviewed by our multidisciplinary child protection team. Demographic, clinical, and socioeconomic data were analyzed to identify risk indicators for maltreatment.
Results
A total of 862 pediatric patients were included. At the time of admission, 25 cases (2.9%) were classified as confirmed child maltreatment. However, retrospective evaluation revealed a higher number of suspected maltreatment cases, including neglect or abuse (73 patients, 10.8%).
| Neglect | Physical Abuse | No NAI | Total | |
| Male | 11 (3.2%) |
25 (7.3%) |
306 (89.5%) |
342 (100.0%) |
| Female |
27 (5.2%) |
30 (5.8%) |
463 (89.0%) |
520 (100.0%) |
| Total |
38 (4.4%) |
55 (6.4%) |
769 (89.2%) |
862 (100.0%) |
Discussion
The actual incidence of child maltreatment in pediatric burn patients is likely higher than initially recognized. Our findings suggest that neither parental age nor area-level income significantly predicted maltreatment risk. Instead, the most reliable indicator was an inconsistent or incongruent injury history.
These results highlight the importance of structured assessment and retrospective review in identifying at-risk children and underline the need for improved vigilance in clinical settings. In particular, special attention should be paid to the plausibility of the reported accident history and the described accident mechanism, as these factors are critical in distinguishing accidental injuries from potential maltreatment.