Resumen de Registro multicéntrico de maltrato en urgencias: casuística de un año

Victoria Trenchs Sainz de la Maza, Ana Curcoy Barcenilla

• español

  Objetivo: Se presentan los resultados tras un año de funcionamiento del Registro de Maltrato de la Sociedad Española de Urgencias de Pediatría cuya finalidad es conocer cuál es la realidad acerca de este motivo de consulta.

  Método: Estudio prospectivo multicéntrico. Se incluyen los pacientes menores de 15 años atendidos por sospecha de maltrato en 13 servicios de urgencias.

  Resultados: Se recogieron 471 casos (9/10.000 consultas; edad mediana de 5,2 años; 58,6% niñas). El 37,8% corresponden a abuso sexual, el 37,2% a maltrato físico, el 20,6% a negligencia y el 4,5% a maltrato emocional. En el 38,2% se implica al médico de atención primaria, en el 94,5% a los servicios sociales, en el 50,5% al juzgado y en el 16,8% al médico forense. Según el grado, el 51,2% son casos moderados, el 29,9% leves y el 18,9% graves. El 76,9% son dados de alta a domicilio, el 9,8% a un centro de acogida, el 13,0% ingresan y el 0,4% fallecen. El abuso sexual y el emocional son más frecuentes en niñas (79,7% y 63,8%) mientras que el maltrato físico y la negligencia lo son en niños (54,5% y 56,6%; p < 0,001). Los atendidos por negligencia son menores que el resto (mediana 1,9 años vs 5,8 años en abusos sexual y maltrato físico y 6,9 años en emocional; p < 0,001).

  Conclusiones: Las consultas a urgencias por maltrato son poco frecuentes; sin embargo, la mayoría son de grado moderado-grave y requieren de la atención conjunta de diferentes profesionales que garanticen la protección del menor. Se constata que los abusos sexuales afectan mayoritariamente a niñas y los casos de negligencia a lactantes.

• English

  Background and objective: The Child Abuse Registry of the Spanish Society of Pediatric Emergency Medicine was created to determine the frequency of emergency department visits with abused children. Our aim of was to analyze the results for the first year of reporting to the case registry.

  Methods: Prospective multicenter study. The 13 emergency departments participating in the project reported cases in which patients under the age of 15 years had injuries that were believed to be caused by abuse.

  Results: A total of 471 cases (9 per 10 000 visits) were attended; the mean age was 5.2 years, and 58.6% of the patients were girls. Abuse was sexual in 37.8% of the cases; physical violence accounted for 37.2%, negligence for 20.6%, and emotional abuse for 4.5%. The primary care physician was notified in 38.2% of the cases, social services in 94.5%, the courts in 50.5%, and the department of forensic medicine in 16.8%. Injuries were moderate in 51.2%, minor in 29.9%, and serious in 18.9%. The patient was discharged home in 76.9% of the cases and to a shelter in 9.8%. Thirteen percent of the patients were hospitalized and 0.4% died. Cases of sexual and emotional abuse are more common in girls (79.7% and 63.8%, respectively). Physical abuse and negligence are more common in boys (54.5% and 56.6%) (P<.001). Cases of negligence involve younger children (median age, 1.9 years) while other forms of abuse occur in older children (median age 5.8 years for sexual and physical abuse and 6.9 years for emotional abuse) (P<.001).

  Conclusions: Visits to the emergency room to treat injuries resulting from abuse are not frequent. Most cases that do reach the emergency department, however, involve injuries that are moderate or serious and various types of professional intervention are required to guarantee the child�s safety. Visits for sexual abuse more often involve girls, while cases of negligence more often involve infants or toddlers.