Temporal Trends of Abusive Pediatric Fractures: a Retrospective Studytext_resourcesBackground: Child maltreatment is a significant public health concern, affecting 1 in 4 children. Of these, 20% experience physical abuse, with fractures as the second most common presentation. Previous studies have examined temporal trends in pediatric fractures, noting higher rates during warmer temperatures, weekends, and evenings. However, research on the temporal trends of abusive pediatric fractures is limited, and this knowledge could aid in the detection and treatment of such injuries. Methods: This retrospective observational study evaluates temporal trends in abusive pediatric fractures among children ≤5 years who presented to Hasbro ED between March 2015 and April 2023 with 1+ fracture diagnoses. Data collected included demographic information, encounter temporality (e.g., time of day, day of week, and season), CAP recommendations for abuse workups, and CAP determinations of fracture etiology. Descriptive statistics and chi-squared analyses were conducted. Results: Of 4,285 encounters, 10.7% (N=458) had a CAP consult, and 36.7% (N=168) of CAP consults had a child abuse workup. 1.1% (N=47) of encounters were determined to have a fracture due to abuse/neglect. Weekday vs. weekend and seasonal distribution of encounters differed significantly based on CAP consult, CAP recommendation, and CAP fracture etiology determination. Shift distribution differed significantly by CAP consult and recommendations only. Conclusions: There are significant temporal differences in the proportion ED encounters with CAP consults and in CAP consults with abuse workups. These findings differ from those in previous literature. Due to the observational nature of the study, causality cannot be established. Further research is needed across various clinical and climate settings, as well as investigations into the underlying reasons for these trends.Kim, Grace J.AuthorLin, TimmyAuthorRudman, WilliamAuthorDuffy, SusanAuthorRuest, StephanieAuthorBrown University. Alpert Medical School. Scholarly Concentration Program. Non-Scholarly Concentratorresearch programChild abuseFracturesPediatric emergencies--PreventionPediatric trauma centersEnglish2024Non-Scholarly ConcentratorAll rights reservedIn CopyrightAll Rights Reserved