Anbesaw W Selassie1, Keith Borg, Carrie Busch, W Scott Russell. 1. From the Divisions of *Epidemiology and Biostatistics and †Emergency Medicine and Pediatric Emergency Medicine, Department of Medicine; and Divisions of ‡Pediatric Emergency Medicine and Violence Intervention and Prevention and §Pediatric Emergency Medicine, Department of Pediatrics, Medical University of South Carolina, Charleston, SC.
Abstract
OBJECTIVE: The objectives of this study were to provide population-based incidence estimate of abusive head trauma (AHT) in children aged 0 to 5 years from inpatient and emergency department (ED) and identify risk characteristics for recognizing high-risk children to improve public health surveillance. METHODS: This was a retrospective cohort study based on children's first encounter in ED or hospital admission with a diagnosis of head trauma (HT), 2000-2010. The relationship between clinical markers and AHT was examined controlling for covariables in the model using Cox hazards regression. Kaplan-Meier incidence probability was plotted, and the number of weeks elapsing from date of birth to the first encounter with HT established the survival time (T). RESULTS: Twenty-six thousand six hundred eighty-one children had HT, 502 (1.8%) resulted from abuse; 42.4% was captured from ED. Incidence varied from 28.9 (95% confidence interval [CI], 27.9-37.4) in infants to 4.1 (95% CI, 2.4-5.7) in 5-year-olds per 100,000 per year. Adjusted hazard ratio was 20.3 (95% CI, 10.9-38.0) for intracranial bleeding and 11.4 (95% CI, 8.57-15.21) for retinal hemorrhage. CONCLUSIONS: Incidence estimates of AHT are incomplete without including ED. Intracranial bleeding is a cardinal feature of AHT to be considered in case ascertainment to improve public health surveillance.
OBJECTIVE: The objectives of this study were to provide population-based incidence estimate of abusive head trauma (AHT) in children aged 0 to 5 years from inpatient and emergency department (ED) and identify risk characteristics for recognizing high-risk children to improve public health surveillance. METHODS: This was a retrospective cohort study based on children's first encounter in ED or hospital admission with a diagnosis of head trauma (HT), 2000-2010. The relationship between clinical markers and AHT was examined controlling for covariables in the model using Cox hazards regression. Kaplan-Meier incidence probability was plotted, and the number of weeks elapsing from date of birth to the first encounter with HT established the survival time (T). RESULTS: Twenty-six thousand six hundred eighty-one children had HT, 502 (1.8%) resulted from abuse; 42.4% was captured from ED. Incidence varied from 28.9 (95% confidence interval [CI], 27.9-37.4) in infants to 4.1 (95% CI, 2.4-5.7) in 5-year-olds per 100,000 per year. Adjusted hazard ratio was 20.3 (95% CI, 10.9-38.0) for intracranial bleeding and 11.4 (95% CI, 8.57-15.21) for retinal hemorrhage. CONCLUSIONS: Incidence estimates of AHT are incomplete without including ED. Intracranial bleeding is a cardinal feature of AHT to be considered in case ascertainment to improve public health surveillance.
Authors: Yesha S Shah; Mustafa Iftikhar; Grant A Justin; Joseph K Canner; Fasika A Woreta Journal: JAMA Ophthalmol Date: 2022-03-01 Impact factor: 7.389
Authors: Kent P Hymel; Veronica Armijo-Garcia; Matthew Musick; Mark Marinello; Bruce E Herman; Kerri Weeks; Suzanne B Haney; Terra N Frazier; Christopher L Carroll; Natalie N Kissoon; Reena Isaac; Robin Foster; Kristine A Campbell; Kelly S Tieves; Nina Livingston; Ashley Bucher; Maria C Woosley; Dorinda Escamilla-Padilla; Nancy Jaimon; Lucinda Kustka; Ming Wang; Vernon M Chinchilli; Mark S Dias; Jennie Noll Journal: J Pediatr Date: 2021-03-31 Impact factor: 6.314