NCJ Number
246921
Journal
Child Abuse and Neglect Volume: 37 Issue: 7 Dated: July 2013 Pages: 446-455
Date Published
July 2013
Length
10 pages
Annotation
Abusive head trauma AHT is a leading cause of severe injury in maltreated children in the United States.
Abstract
Abusive head trauma AHT is a leading cause of severe injury in maltreated children in the United States. There is little research from nationally representative datasets available to characterize young children who had AHT compared to non-abusive head trauma NAHT. Using the recent CDC AHT case definition, we performed a retrospective analysis of 2000, 2003, 2006 and 2009 hospitalization data using the Kids' Inpatient Database KID from the Healthcare Cost and Utilization Project. Logistic regression was used to compare AHT to NAHT patients <2 years of age. Socio-demographic data and indicators of socioeconomic status i.e., insurance status and household income, presence of chronic conditions, injury severity i.e., length of hospital stay and vital status, hospital specialization i.e., hospital type, hospital region, and season of admission were used as independent variables. A weighted sample of 7,603 AHT and 25,339 NAHT patients was identified. National rates for AHT were 39.8 per 100,000 population for children <1 year and 6.8 per 100,000 population for children 1 year old. Compared to NAHT, children with AHT were more often <1 year of age adjusted odds ratio aOR = 2.66; 95% confidence interval CI: 2.35-3.01, male aOR = 1.10; 95% CI: 1.01-1.20, enrolled in Medicaid aOR = 2.78; 95% CI: 2.49-3.11, hospitalized longer aOR = 8.26; 95% CI: 7.24-9.43, died during hospitalization aOR = 5.12; 95% CI: 4.01-6.53, and seen at children's hospitals aOR = 1.97; 95% CI: 1.63-2.38 and hospitals outside the Northeast aOR = 2.65 95% CI: 2.10-3.33 for the Midwest, 1.90 95% CI: 1.52-2.38 for the South and 1.93 95% CI: 1.45-2.57 for the West, respectively. The results confirm that injuries from AHT are more severe and more often lethal than other head injuries. Socioeconomically disadvantaged families with children <1 year are an important focus for primary prevention. The associations of AHT, compared to NAHT with hospital type and hospital region warrant further investigation. Referral or reporting patterns, or true differences in the incidence may contribute to the identified associations.