Using Hospital Discharge Data to Track Inflicted Traumatic Brain Injury

Ellingson, Katherine; Leventhal, John M.; Weiss, Harold B.

doi:10.1016/j.amepre.2007.12.021

Cited by 101 publications

(62 citation statements)

References 11 publications

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“…18,19 Also consistent with other findings, children who were black, had public insurance or no insurance, and those from lowerincome neighborhoods, when compared with white children, privately insured, and those from higher-income areas, were more likely to be admitted for injury from abuse than for other reasons for admission. 9,18,20,21 The severity of injuries of hospitalized children increased slightly but significantly over the study period.…”

Section: Discussionmentioning

confidence: 99%

“…Health professionals are recognized as being in an important position to document evidence of child abuse. [8][9][10] In the absence of population-based linked databases, hospital morbidity data could provide an efficient, nationally standardized source of information on child abuse. 4,8 Hospitals use a standard system to describe diagnoses related to medical care that is required by insurers.…”

Section: E1796mentioning

confidence: 99%

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Trends in Hospitalization Rates and Severity of Injuries From Abuse in Young Children, 1997–2009

Farst

Ambadwar²,

King³

et al. 2013

Pediatrics

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OBJECTIVES: To examine trends in incidence of hospitalizations for injury from abuse in young children from 1997 through 2009 and to examine injury severity trends. METHODS: Cases were identified in the National Inpatient Sample database of the Healthcare Cost and Utilization Project by using International Classification of Diseases, Ninth Revision, Clinical Modification codes for child maltreatment and external cause of injury for assault in children aged 0 through 3 years. Incidence was calculated by age, gender, and region. Trends in incidence of hospitalization and injury severity were calculated over time. RESULTS: Hospitalization rates for injury from abuse showed no significant change over the study period, ranging from a low of 2.10 per 10 000 children in 1998 to a high of 3.01 per 10 000 children in 2005 (P = .755). Children aged <1 had significantly higher hospitalization rates for injury from abuse (6.01 vs 1.12, P <.001) and higher mean injury severity scores compared with children aged 1 to 3 years (12.50, SD = 0.14 vs 8.56, SD = 0.21, P <.001). Injury severity scores increased significantly over the study period. CONCLUSIONS: No significant change in hospitalization rates for injury from abuse among young children was observed from 1997 to 2009. These results coincide with other reports of stable or modestly increasing rates of serious physical abuse or death in young children but not with reports from child welfare data showing declines in physical abuse during the same period. Diverse sources of data may provide important complementary methods to track child abuse.

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Section: Discussionmentioning

confidence: 99%

Section: E1796mentioning

confidence: 99%

Trends in Hospitalization Rates and Severity of Injuries From Abuse in Young Children, 1997–2009

Farst

Ambadwar²,

King³

et al. 2013

Pediatrics

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“…Recalculated incidence rates from this study (unpublished results) for infants and children Ͻ 24 months, and expressed per 100,000 person-years according to the methods of Keenan et al, 16 yields an incidence of 19.4 cases per 100,000 person-years for the first 2 years of life with higher incidence rates in the 1st year compared with the 2nd year (36.5 cases vs 2.5 cases per 100,000 person-years, respectively). Finally, Ellingson et al 11 studied only infants Ͻ 12 months of age with AHT identified from the Kids In-Patient Database (Agency for Healthcare and Research Quality) and calculated respective incidence rates of 23.2, 23.6, and 26.1 cases per 100,000 person-years for the 1997, 2000, and 2003 data sets. The incidence rates averaged from all studies (Table 1) were 17.0 (range 14.7-19.4) per 100,000 person-years for the first 2 years of life, 28.2 (range 24.3-36.5) for the 1st year of life and 3.2 (range 2.5-3.8) per 100,000 personyears for the 2nd year of life.…”

Section: Discussionmentioning

confidence: 99%

Demographics of abusive head trauma in the Commonwealth of Pennsylvania

Kesler¹,

Dias²,

Shaffer

et al. 2008

PED

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Object The aim of this study was to characterize the prevalence and demographic features of abusive head trauma (AHT) among infants and children < 36 months of age in Pennsylvania. Methods The authors included all cases of substantiated AHT involving children < 36 months of age in Pennsylvania between 1996 and 2002 that had been reported to a statewide registry. Demographic information was derived from child abuse reports and birth certificates; the study cohort was contrasted with all infants born in Pennsylvania during the same period. Results The study identified 327 cases. The incidence was 14.7 cases (95% confidence interval 13.1–16.5) per 100,000 person-years for the first 2 years of life with a higher incidence during the 1st year (26.0 cases per 100,000 person-years) than the 2nd year (3.4 cases per 100,000 person-years). The incidence was similar among metropolitan, non-metropolitan, and rural counties. Significantly more cases occurred during the holiday months (October–December). The median age of victims was 4.1 months. Both victims and perpetrators were more commonly male (58.4% of victims, and 70% of identified perpetrators). Compared with the entire population of Pennsylvania parents, the parents of the study cohort were more likely to be younger, less educated, and unmarried. Both mothers and fathers were more often African-American and fathers more often Hispanic. Finally, mothers more often smoked during pregnancy, sought prenatal care later in the pregnancy, and delivered low birth weight infants. Conclusions This population-based study of abusive head injuries throughout an entire state adds significantly to the growing knowledge about this condition. The results suggests that families of infants with abusive head injuries have significantly different demographic features compared with the general population, although which of these variables is independently significant cannot be ascertained from this study and require further investigation.

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“…1 It was first described .40 years ago, and the epidemiology of AHT is now more clearly understood, with reported rates of approximately 15-30 per 100 000 in the first year of life. [2][3][4][5][6] This translates to about 1200 cases among children ,1 year of age per year in the United States. Nearly one-fourth of children ,2 die, and the costs to the child, family, health system, and society are enormous.…”

mentioning

confidence: 99%

National, Regional, and State Abusive Head Trauma: Application of the CDC Algorithm

et al. 2013

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WHAT'S KNOWN ON THIS SUBJECT: Abusive head trauma (AHT) is a rare phenomenon that results in devastating injuries to children. It is necessary to analyze large samples to examine changes in rates over time. WHAT THIS STUDY ADDS:This is the first study to examine rates of AHT at the national, regional, and state level. The results provide a more detailed description of AHT trends than has been previously available. abstract OBJECTIVE: To examine national, regional, and state abusive head trauma (AHT) trends using child hospital discharge data by applying a new coding algorithm developed by the Centers for Disease Control and Prevention (CDC). METHODS:Data from 4 waves of the Kids' Inpatient Database and annual discharge data from North Carolina were used to determine trends in AHT incidence among children ,1 year of age between 2000 and 2009. National, regional, and state incidence rates were calculated. Poisson regression analyses were used to examine national, regional, and state AHT trends. RESULTS:The CDC narrow and broad algorithms identified 5437 and 6317 cases, respectively, in the 4 years of KID weighted data. This yielded average annual incidences of 33.4 and 38.8 cases per 100 000 children ,1 year of age. There was no statistically significant change in national rates. There were variations by region of the country, with significantly different trends in the Midwest and West. State data for North Carolina showed wide annual variation in rates, with no significant trend. CONCLUSIONS:The new coding algorithm resulted in the highest AHT rates reported to date. At the same time, we found large but statistically insignificant annual variations in AHT rates in 1 large state. This suggests that caution should be used in interpreting AHT trends and attributing changes in rates as being caused by changes in policies, programs, or the economy. Pediatrics 2013;132:e1546-e1553 AUTHORS:

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Using Hospital Discharge Data to Track Inflicted Traumatic Brain Injury

Cited by 101 publications

References 11 publications

Trends in Hospitalization Rates and Severity of Injuries From Abuse in Young Children, 1997–2009

Trends in Hospitalization Rates and Severity of Injuries From Abuse in Young Children, 1997–2009

Demographics of abusive head trauma in the Commonwealth of Pennsylvania

National, Regional, and State Abusive Head Trauma: Application of the CDC Algorithm

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