SDC 2. Comparative studies of burn injuries in children.
Author, year Study type/Aim Inclusion criteria Outcomes Abuse definition (confirmation of
abuse)†
Findings/Effect
size Level of Evidence Burns
Maguire S et al. (2008), (48)
Systematic review / To identify distinguishing features of intentional and unintentional scalds
26 studies of children 0-18 years with validated intentional or unintentional scald burns. Excluded neglect; n = 587 total children; n = 183 children with abusive scald injury; n = 404 children with accidental scalds.
Meta-analysis not performed due to study
heterogeneity.
Characterize intentional vs.
unintentional scald burns
1: Confirmed at case conference, court proceedings or admitted by perpetrator 2: Confirmed by stated criteria including multidisciplinary assessment
Effect size not performed Proposed Triage tool (Table 3)
Level III
Hodgman EI et al. (2016), (51)
Retrospective review of prospective database 1) To identify characteristics associated with intentional burn injury
Large single center study, children 0-18 years admitted with burn injury 1974- 2010; n = 5553 total burns; n = 392 children referred to CPS; n = 297 children confirmed abuse
Review the characteristics independently associated with confirmed abuse
3 – Based on interview by social work staff, Child Protective Services and REACH (Referral and
Evaluation of At-Risk Children) Service (pediatricians trained in child abuse)
Odds Ratio (95%
CI)” Age: 0.89 (0.84-0.94)’
Chemical burn:
24.6 (4.94-135);
Contact burn: 5.2 (1.6-22.9); Scald burn: 17.4 (6.4- 72); Burn to chest:
0.28 (0.17-0.44);
Burn to feet: 6.3 (4.6-8.6); Burn to buttocks: 3.1 (2.2- 4.5); Burn to perineum: 2.5 (1.7-3.7)
Level II
* Torso defined as chest, abdomen, back, buttocks, genitourinary region, hip
†NAT was defined in each report by meeting one of the following criteria as proposed by Maguire, et al. (14):
1. Abuse confirmed at case conference, family, civil or criminal court proceedings or admitted by perpetrator or witnessed
2. Abuse confirmed by stated criteria where diagnosis was based upon additional features and did not rely on the variable of interest, and included multidisciplinary assessment
3. Abuse defined by stated criteria
4. Abuse stated as occurring, but no supporting detail given as to how it was determined 5. Abuse stated simply as “suspected"
