Beth Bloom Emrick1, Eleanor Smith2, Lauren Thompson3, Charles Mullett2, Eduardo Pino3, Katherine Snyder4, Mary-Ann Kroll2, Susan Ayoubi5, Joan Phillips5, Sharon Istfan5, Christine A Welch6, James E McJunkin5. 1. Charleston Area Medical Center/West Virginia University - Charleston Division, Charleston, WV, United States. Electronic address: beemrick@hsc.wvu.edu. 2. West Virginia University School of Medicine, Morgantown, WV, United States. 3. Marshall University School of Medicine, Huntington, WV, United States. 4. University of Texas Dell Medical School, Austin, TX, United States. 5. Charleston Area Medical Center/West Virginia University - Charleston Division, Charleston, WV, United States. 6. Health Education and Research Institute, Outcomes Research, Charleston Area Medical Center, Charleston, WV, United States.
Abstract
BACKGROUND: Few states have published statewide epidemiology of abusive head trauma (AHT). OBJECTIVE: To examine the statewide epidemiology of AHT in West Virginia (WV), with the primary objective of establishing AHT incidence for comparison to national data, and to use as a baseline for comparison to incidence post-implementation of a statewide AHT prevention program. PARTICIPANTS AND SETTING: AHT cases in children less than 2 years old were identified from the 3 tertiary pediatric centers in WV. METHODS: Cases were identified by using ICD-9 codes for initially identifying those with injuries which might be consistent with AHT, followed by medical record review to determine which of these met the criteria for inclusion as a case. Medical examiner data was used to find additional cases of AHT. Using the number of cases identified along with relevant census data, incidence of AHT was calculated. RESULTS: There were 120 cases of AHT treated in WV hospitals from 2000 to 2010, 100 of which were WV residents. The incidence was 36.1/100,000 children <1 year of age and was 21.9 cases per 100,000 children <2 years of age. Incidence in infants increased during the latter years (2006-2010) of the study to 51.8/100,000 compared to the incidence during 2000-2005, which was 24.0/100,000 (p < .01). CONCLUSIONS: Compared to US national, state and regional figures, the WV incidence of AHT was among the highest. In addition, the incidence of AHT increased significantly over the study period. Possible factors contributing to the rise in incidence are discussed.
BACKGROUND: Few states have published statewide epidemiology of abusive head trauma (AHT). OBJECTIVE: To examine the statewide epidemiology of AHT in West Virginia (WV), with the primary objective of establishing AHT incidence for comparison to national data, and to use as a baseline for comparison to incidence post-implementation of a statewide AHT prevention program. PARTICIPANTS AND SETTING:AHT cases in children less than 2 years old were identified from the 3 tertiary pediatric centers in WV. METHODS: Cases were identified by using ICD-9 codes for initially identifying those with injuries which might be consistent with AHT, followed by medical record review to determine which of these met the criteria for inclusion as a case. Medical examiner data was used to find additional cases of AHT. Using the number of cases identified along with relevant census data, incidence of AHT was calculated. RESULTS: There were 120 cases of AHT treated in WV hospitals from 2000 to 2010, 100 of which were WV residents. The incidence was 36.1/100,000 children <1 year of age and was 21.9 cases per 100,000 children <2 years of age. Incidence in infants increased during the latter years (2006-2010) of the study to 51.8/100,000 compared to the incidence during 2000-2005, which was 24.0/100,000 (p < .01). CONCLUSIONS: Compared to US national, state and regional figures, the WV incidence of AHT was among the highest. In addition, the incidence of AHT increased significantly over the study period. Possible factors contributing to the rise in incidence are discussed.