Trends in pediatric abusive head trauma

Introduction: Abusive head trauma (AHT) is the leading cause of death from injury in infants. The purpose of this study was to identify environmental and sociodemographic trends in pediatric AHT patients at Children's Hospital of Alabama (CHA).

Methods: A retrospective chart review was conducted to identify patients treated for abusive head trauma between the years 2008 and 2010. Electronic medical records were complemented with admit, discharge, transfer data, along with social work and neurosurgical records. Descriptive statistics and exploratory analysis were performed using SAS 9.2.

Results: Of the approximate 80 to 90 head trauma consults, 46 were determined to be AHT victims. Of those 46 identified, 6 (13%) died prior to hospital discharge. The median age of patients was 4 months (range 0 to 66 months). The median guardian age was 26 years (range 17 to 46 years). The median distance of injury from CHAwas 66 miles with the majority of families living in rural areas. Significant social findings included birth order and perpetrator. There were no time variables found to be statistically significant, including seasonality, admission time and day of the week. Conclusion: Although national data suggests AHT injuries have decreased, incidence of AHT at CHA has not changed over time. This study did identify trends; however, preliminary analysis did not show any factors to be statistically significant. These results highlight AHT as a public health problem and the need for continued investigation into the best practices for treating and preventing AHT.