In the JournalsPerspective

ED admissions for adolescent sexual abuse double

The number of ED admissions related to confirmed adolescent sexual abuse more than doubled from 2010 through 2016 in the United States, according to research published in JAMA Pediatrics.

Jesse J. Helton, PhD, assistant professor of social work at the Saint Louis University College for Public Health and Social Justice, and colleagues analyzed data from hospital EDs in the U.S. between Jan. 1, 2010, and Dec. 31, 2016, representing nearly 80% of all ED admissions. They weighted the data to create national estimates.

According to the study, during the study period, there were 190,444,745 ED admissions involving children. Of these, 46,993 were for confirmed sexual abuse. Most patients (85.14%) were female, and 44.75% were aged 12 to 17 years.

Helton and colleagues identified 5,138 sexual abuse-related admissions in 2010, and 8,818 admissions in 2016. The researchers reported a spike in the rate of these admissions from 6.93 to 11.97 admissions per 100,000 children aged younger than 18 years during the study period.

According to the researchers, the increase in the rate of sexual abuse cases may be associated with an increase in the number of adolescent ED admissions during the study period. Adolescents accounted for 44.37% of all ED admissions in 2010 but 57.36% of all admissions in 2016.

Helton and colleagues noted that the rate of sexual abuse-related admissions increased from 8.02 to 20.2 per 100,000 adolescents in the U.S.

According to the researchers, ED physicians can assist in providing testing and treatment for STIs, HIV prophylaxis and emergency contraception for children who report sexual abuse. Further, some providers perform forensic examinations to help with child protection and criminal investigations.

“Our data did not allow us to identify factors that may have been associated with this increase,” they wrote. “Several leading possibilities include the increased number of girls who were subjected to sex trafficking and the greater awareness and sensitivity of medical professionals regarding sexual assault. The increased rates of sexual abuse cases observed in this study are coupled with an ongoing concern about the quality of care and the treatment of sexually abused children who are admitted to EDs, which may not consistently adhere to the recommendations for care endorsed by the AAP and the CDC.” – by Katherine Bortz

Disclosures: The authors report no relevant financial disclosures.

The number of ED admissions related to confirmed adolescent sexual abuse more than doubled from 2010 through 2016 in the United States, according to research published in JAMA Pediatrics.

Jesse J. Helton, PhD, assistant professor of social work at the Saint Louis University College for Public Health and Social Justice, and colleagues analyzed data from hospital EDs in the U.S. between Jan. 1, 2010, and Dec. 31, 2016, representing nearly 80% of all ED admissions. They weighted the data to create national estimates.

According to the study, during the study period, there were 190,444,745 ED admissions involving children. Of these, 46,993 were for confirmed sexual abuse. Most patients (85.14%) were female, and 44.75% were aged 12 to 17 years.

Helton and colleagues identified 5,138 sexual abuse-related admissions in 2010, and 8,818 admissions in 2016. The researchers reported a spike in the rate of these admissions from 6.93 to 11.97 admissions per 100,000 children aged younger than 18 years during the study period.

According to the researchers, the increase in the rate of sexual abuse cases may be associated with an increase in the number of adolescent ED admissions during the study period. Adolescents accounted for 44.37% of all ED admissions in 2010 but 57.36% of all admissions in 2016.

Helton and colleagues noted that the rate of sexual abuse-related admissions increased from 8.02 to 20.2 per 100,000 adolescents in the U.S.

According to the researchers, ED physicians can assist in providing testing and treatment for STIs, HIV prophylaxis and emergency contraception for children who report sexual abuse. Further, some providers perform forensic examinations to help with child protection and criminal investigations.

“Our data did not allow us to identify factors that may have been associated with this increase,” they wrote. “Several leading possibilities include the increased number of girls who were subjected to sex trafficking and the greater awareness and sensitivity of medical professionals regarding sexual assault. The increased rates of sexual abuse cases observed in this study are coupled with an ongoing concern about the quality of care and the treatment of sexually abused children who are admitted to EDs, which may not consistently adhere to the recommendations for care endorsed by the AAP and the CDC.” – by Katherine Bortz

Disclosures: The authors report no relevant financial disclosures.

    Perspective

    As clinicians, primary care providers are the first line of defense in prevention. They can teach all parents and children about body safety, such as knowing the correct terms for body parts, that some body parts are private, and that body secrets are not OK. They should screen all pediatric patients at wellness visits and warranted episodic visits (eg, painful urination, STDs, vague abdominal pain), and they should know what to do and where to refer if their evaluation turns up positive results.

    Advocacy is also critical. EDs are not the best agencies to manage child sexual abuse. Children’s Advocacy Center personnel know how to handle trauma, disclosure, forensic exams and working with multiple professionals, including law enforcement and child protective services. If none exist locally, PCPs can work with their county’s district attorney and victims’ resource center to examine the feasibility of creating one.

    • Mary Muscari, PhD
    • Associate professor
      Director, forensic health program
      Coordinator, family psychiatric mental health nurse practitioner program
      Decker College of Nursing and Health Sciences
      Binghamton University

    Disclosures: Infectious Diseases in Children was unable to confirm relevant financial disclosures prior to publication.