Age and Outcome of Inpatients Evaluated for Possible Physical Abuse at a Tertiary Children`s Hospital in Greece

Background: There is no child abuse registry in Greece.

Objective: To determine the age and outcome of inpatients evaluated for possible physical abuse at a tertiary children’s hospital in Greece.

Methods: Children aged 0 – 16 years with a report of physical abuse to the juvenile attorney or with injuries and social concerns hospitalized from January 2014–December 2015 were retrospectively identified from the handwritten archives of the hospital departments of Social Work and Child Psychiatry. Based on paper records and imaging studies, two pediatricians and two radiologists reached a consensus rating on the likelihood of abuse on each case using a 7-point Clinical Abuse Scale with three levels of confidence for abuse (definite, likely, and questionable), an indeterminate middle rating and 3 levels of confidence for accident (definite, likely, and questionable). Place of discharge was noted as protected (kinship or institution) or unprotected (home or unknown).

Results:

Of the 39 patients identified:

• The mean age was 6.8 years (1.5 months - 16 years).
• Reports to the juvenile attorney were made by the community in 26 and by hospital physicians in 7 patients.
• 6 additional patients were reviewed due to injuries and social concerns.
• The researchers categorized 22 as definite abuse, 2 as likely abuse, 4 as questionable abuse, 3 as likely accident and 8 as indeterminate cause.
• All 6 infants were categorized as abuse: 3 definite, 1 likely and 2 questionable.

Of the 28 patients categorized as abuse:

• The mean age was 7.7 years (1.5 months – 16 years).
• 2 died (charges were pressed against the caregivers of one deceased child).
• 10 were discharged to an unprotected, and 16 to a protected environment.

Conclusion: This review of 39 inpatients evaluated for possible physical abuse at a children’s hospital in Greece suggests suboptimal detection and management of child abuse.