Hospitalisations for physical abuse in infants and children less than 5 years, 2013–2021: a multinational cohort study using administrative data from five European countries

Catherine Quantin; Jonathan Cottenet; Colleen Chambers; Natasha Kennedy; Sadhbh Whelan; Geoff Debelle; Diogo Lamela; Ulugbek Nurmatov; Donna O'Leary; Christian Torp-Pedersen; Sinéad Brophy; Marcella Broccia; Ruth Gilbert; Troels Græsholt-Knudsen; Laura Elizabeth Cowley

doi:10.1016/j.lanepe.2025.101270

Hospitalisations for physical abuse in infants and children less than 5 years, 2013–2021: a multinational cohort study using administrative data from five European countries

Catherine Quantin^*, Jonathan Cottenet, Colleen Chambers, Natasha Kennedy, Sadhbh Whelan, Geoff Debelle, Diogo Lamela, Ulugbek Nurmatov, Donna O'Leary, Christian Torp-Pedersen, Sinéad Brophy, Marcella Broccia, Ruth Gilbert, Troels Græsholt-Knudsen, Laura Elizabeth Cowley

^*Corresponding author for this work

Department of Forensic Medicine - Department of Forensic Medicine - Forensic Pathology

Research output: Contribution to journal/Conference contribution in journal/Contribution to newspaper › Journal article › Research › peer-review

Abstract

Background: Child physical abuse (CPA) is a global public health problem associated with lifelong negative consequences, yet reliable epidemiologic data are lacking. This multinational cohort study analyses trends in CPA hospitalisations from 2013 to 2021. Methods: We used medico-administrative databases to identify children aged one month to five years hospitalised in Denmark, England, France, Ireland, and Wales. We identified CPA using a validated algorithm based on ICD-10 codes. We calculated the number, proportion, and incidence rate of children hospitalised for CPA, and the number and proportion of total hospitalisations for CPA, by year and age group (<1 and <5). We determined the proportion of CPA hospitalisations recorded using different ICD-10 codes, by country. Findings: The pooled incidence rate of infants <1 year hospitalised for CPA was stable over time (around 42/100,000 per year), ranging on average from 33 to 48/100,000 between countries. The pooled proportion of infant hospitalisations for CPA was around 0.17% (N = 750) per year (range 0.15–0.21%, N range 674–785), increasing significantly during the COVID-19 pandemic in 2020 (0.21%, N = 674). In children <5, the incidence rate (around 18/100,000 per year) and proportion of CPA hospitalisations (around 0.11% per year (N = 1600), range 0.10–0.14% (N range 1341–1657) were lower than in infants, but also increased in 2020 (0.14%, N = 1341). There were national differences in the distribution of ICD-10 codes used to record CPA and differences in year-on-year trends between countries. Interpretation: Comparing temporal trends in CPA hospitalisations between countries is feasible. Hospital data are one of several valuable sources for CPA surveillance. Funding: European COST Action EURO-CAN. European Union (HORIZON Europe SERENA project).

Original language	English
Article number	101270
Journal	The Lancet Regional Health - Europe
Volume	52
ISSN	2666-7762
DOIs	https://doi.org/10.1016/j.lanepe.2025.101270
Publication status	Published - May 2025

Keywords

Administrative data
Child physical abuse
Hospital data
Incidence

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10.1016/j.lanepe.2025.101270

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Quantin, C., Cottenet, J., Chambers, C., Kennedy, N., Whelan, S., Debelle, G., Lamela, D., Nurmatov, U., O'Leary, D., Torp-Pedersen, C., Brophy, S., Broccia, M., Gilbert, R., Græsholt-Knudsen, T., & Cowley, L. E. (2025). Hospitalisations for physical abuse in infants and children less than 5 years, 2013–2021: a multinational cohort study using administrative data from five European countries. The Lancet Regional Health - Europe, 52, Article 101270. https://doi.org/10.1016/j.lanepe.2025.101270

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title = "Hospitalisations for physical abuse in infants and children less than 5 years, 2013–2021: a multinational cohort study using administrative data from five European countries",

abstract = "Background: Child physical abuse (CPA) is a global public health problem associated with lifelong negative consequences, yet reliable epidemiologic data are lacking. This multinational cohort study analyses trends in CPA hospitalisations from 2013 to 2021. Methods: We used medico-administrative databases to identify children aged one month to five years hospitalised in Denmark, England, France, Ireland, and Wales. We identified CPA using a validated algorithm based on ICD-10 codes. We calculated the number, proportion, and incidence rate of children hospitalised for CPA, and the number and proportion of total hospitalisations for CPA, by year and age group (<1 and <5). We determined the proportion of CPA hospitalisations recorded using different ICD-10 codes, by country. Findings: The pooled incidence rate of infants <1 year hospitalised for CPA was stable over time (around 42/100,000 per year), ranging on average from 33 to 48/100,000 between countries. The pooled proportion of infant hospitalisations for CPA was around 0.17% (N = 750) per year (range 0.15–0.21%, N range 674–785), increasing significantly during the COVID-19 pandemic in 2020 (0.21%, N = 674). In children <5, the incidence rate (around 18/100,000 per year) and proportion of CPA hospitalisations (around 0.11% per year (N = 1600), range 0.10–0.14% (N range 1341–1657) were lower than in infants, but also increased in 2020 (0.14%, N = 1341). There were national differences in the distribution of ICD-10 codes used to record CPA and differences in year-on-year trends between countries. Interpretation: Comparing temporal trends in CPA hospitalisations between countries is feasible. Hospital data are one of several valuable sources for CPA surveillance. Funding: European COST Action EURO-CAN. European Union (HORIZON Europe SERENA project).",

keywords = "Administrative data, Child physical abuse, Hospital data, Incidence",

author = "Catherine Quantin and Jonathan Cottenet and Colleen Chambers and Natasha Kennedy and Sadhbh Whelan and Geoff Debelle and Diogo Lamela and Ulugbek Nurmatov and Donna O'Leary and Christian Torp-Pedersen and Sin{\'e}ad Brophy and Marcella Broccia and Ruth Gilbert and Troels Gr{\ae}sholt-Knudsen and Cowley, {Laura Elizabeth}",

note = "Publisher Copyright: {\textcopyright} 2025 The Author(s)",

year = "2025",

month = may,

doi = "10.1016/j.lanepe.2025.101270",

language = "English",

volume = "52",

journal = "The Lancet Regional Health - Europe",

issn = "2666-7762",

publisher = "Elsevier",

}

Quantin, C, Cottenet, J, Chambers, C, Kennedy, N, Whelan, S, Debelle, G, Lamela, D, Nurmatov, U, O'Leary, D, Torp-Pedersen, C, Brophy, S, Broccia, M, Gilbert, R, Græsholt-Knudsen, T & Cowley, LE 2025, 'Hospitalisations for physical abuse in infants and children less than 5 years, 2013–2021: a multinational cohort study using administrative data from five European countries', The Lancet Regional Health - Europe, vol. 52, 101270. https://doi.org/10.1016/j.lanepe.2025.101270

Hospitalisations for physical abuse in infants and children less than 5 years, 2013–2021: a multinational cohort study using administrative data from five European countries. / Quantin, Catherine; Cottenet, Jonathan; Chambers, Colleen et al.
In: The Lancet Regional Health - Europe, Vol. 52, 101270, 05.2025.

Research output: Contribution to journal/Conference contribution in journal/Contribution to newspaper › Journal article › Research › peer-review

TY - JOUR

T1 - Hospitalisations for physical abuse in infants and children less than 5 years, 2013–2021

T2 - a multinational cohort study using administrative data from five European countries

AU - Quantin, Catherine

AU - Cottenet, Jonathan

AU - Chambers, Colleen

AU - Kennedy, Natasha

AU - Whelan, Sadhbh

AU - Debelle, Geoff

AU - Lamela, Diogo

AU - Nurmatov, Ulugbek

AU - O'Leary, Donna

AU - Torp-Pedersen, Christian

AU - Brophy, Sinéad

AU - Broccia, Marcella

AU - Gilbert, Ruth

AU - Græsholt-Knudsen, Troels

AU - Cowley, Laura Elizabeth

PY - 2025/5

Y1 - 2025/5

N2 - Background: Child physical abuse (CPA) is a global public health problem associated with lifelong negative consequences, yet reliable epidemiologic data are lacking. This multinational cohort study analyses trends in CPA hospitalisations from 2013 to 2021. Methods: We used medico-administrative databases to identify children aged one month to five years hospitalised in Denmark, England, France, Ireland, and Wales. We identified CPA using a validated algorithm based on ICD-10 codes. We calculated the number, proportion, and incidence rate of children hospitalised for CPA, and the number and proportion of total hospitalisations for CPA, by year and age group (<1 and <5). We determined the proportion of CPA hospitalisations recorded using different ICD-10 codes, by country. Findings: The pooled incidence rate of infants <1 year hospitalised for CPA was stable over time (around 42/100,000 per year), ranging on average from 33 to 48/100,000 between countries. The pooled proportion of infant hospitalisations for CPA was around 0.17% (N = 750) per year (range 0.15–0.21%, N range 674–785), increasing significantly during the COVID-19 pandemic in 2020 (0.21%, N = 674). In children <5, the incidence rate (around 18/100,000 per year) and proportion of CPA hospitalisations (around 0.11% per year (N = 1600), range 0.10–0.14% (N range 1341–1657) were lower than in infants, but also increased in 2020 (0.14%, N = 1341). There were national differences in the distribution of ICD-10 codes used to record CPA and differences in year-on-year trends between countries. Interpretation: Comparing temporal trends in CPA hospitalisations between countries is feasible. Hospital data are one of several valuable sources for CPA surveillance. Funding: European COST Action EURO-CAN. European Union (HORIZON Europe SERENA project).

AB - Background: Child physical abuse (CPA) is a global public health problem associated with lifelong negative consequences, yet reliable epidemiologic data are lacking. This multinational cohort study analyses trends in CPA hospitalisations from 2013 to 2021. Methods: We used medico-administrative databases to identify children aged one month to five years hospitalised in Denmark, England, France, Ireland, and Wales. We identified CPA using a validated algorithm based on ICD-10 codes. We calculated the number, proportion, and incidence rate of children hospitalised for CPA, and the number and proportion of total hospitalisations for CPA, by year and age group (<1 and <5). We determined the proportion of CPA hospitalisations recorded using different ICD-10 codes, by country. Findings: The pooled incidence rate of infants <1 year hospitalised for CPA was stable over time (around 42/100,000 per year), ranging on average from 33 to 48/100,000 between countries. The pooled proportion of infant hospitalisations for CPA was around 0.17% (N = 750) per year (range 0.15–0.21%, N range 674–785), increasing significantly during the COVID-19 pandemic in 2020 (0.21%, N = 674). In children <5, the incidence rate (around 18/100,000 per year) and proportion of CPA hospitalisations (around 0.11% per year (N = 1600), range 0.10–0.14% (N range 1341–1657) were lower than in infants, but also increased in 2020 (0.14%, N = 1341). There were national differences in the distribution of ICD-10 codes used to record CPA and differences in year-on-year trends between countries. Interpretation: Comparing temporal trends in CPA hospitalisations between countries is feasible. Hospital data are one of several valuable sources for CPA surveillance. Funding: European COST Action EURO-CAN. European Union (HORIZON Europe SERENA project).

KW - Administrative data

KW - Child physical abuse

KW - Hospital data

KW - Incidence

UR - http://www.scopus.com/inward/record.url?scp=105000460922&partnerID=8YFLogxK

U2 - 10.1016/j.lanepe.2025.101270

DO - 10.1016/j.lanepe.2025.101270

M3 - Journal article

C2 - 40224370

AN - SCOPUS:105000460922

SN - 2666-7762

VL - 52

JO - The Lancet Regional Health - Europe

JF - The Lancet Regional Health - Europe

M1 - 101270

ER -

Hospitalisations for physical abuse in infants and children less than 5 years, 2013–2021: a multinational cohort study using administrative data from five European countries

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Keywords

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