National Center for Injury Prevention and Control-Division of Violence Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA.
Inj Prev. 2012 Dec;18(6):392-8. doi: 10.1136/injuryprev-2011-040234. Epub 2012 Feb 10.
An International Classification of Diseases code-based case definition for non-fatal abusive head trauma (AHT) in children <5 years of age was developed in March 2008 by an expert panel convened at the Centers for Disease Control and Prevention (CDC). This study presents an application of the CDC recommended operational case definition of AHT to US hospital inpatient data to characterise the AHT hospitalisation rate for children <5 years of age.
Nationwide Inpatient Sample (NIS) data from the Healthcare Cost and Utilisation Project from 2003 to 2008 were examined.
Inspection of the NIS data resulted in the identification of an estimated 10 555 non-fatal AHT hospitalisations with 9595 classified as definite/presumptive AHT and 960 classified as probable AHT. The non-fatal AHT rate was highest among children aged <1 year (32.3 per 100 000) with a peak in hospitalisations between 1 and 3 months of age. Non-fatal AHT hospitalisation rates for children <2 years of age were higher for boys (21.9 per 100 000) than girls (15.3 per 100 000). The non-fatal AHT hospitalisation rate showed little variation across seasons.
To reduce the burden of AHT in the USA, a preventable public health problem, concerted prevention efforts targeting populations at risk should be implemented. This report demonstrates a model procedure for using the new CDC definition for public health surveillance and research purposes. Such findings can be used to inform parents and providers about AHT (eg, dangers of shaking, strategies for managing infant crying) as well as to monitor better the impact of prevention strategies over time.
2008 年 3 月，疾病控制与预防中心（CDC）召集专家小组制定了一个基于国际疾病分类编码的非致命性虐待性头部创伤（AHT）儿童病例定义，该定义适用于 5 岁以下儿童。本研究应用 CDC 推荐的 AHT 操作性病例定义，对美国住院患者数据进行分析，以描述 5 岁以下儿童 AHT 住院率。
对 2003 年至 2008 年医疗保健成本和利用项目的全国住院患者样本（NIS）数据进行了检查。
对 NIS 数据的检查确定了大约 10555 例非致命性 AHT 住院病例，其中 9595 例被归类为明确/推定 AHT，960 例被归类为可能 AHT。1 岁以下儿童的非致命性 AHT 发生率最高（每 10 万人中 32.3 例），1 至 3 个月龄的住院高峰。2 岁以下儿童的非致命性 AHT 住院率，男孩（每 10 万人 21.9 例）高于女孩（每 10 万人 15.3 例）。非致命性 AHT 住院率在各季节变化不大。
为了减少美国可预防的公共卫生问题 AHT 带来的负担，应针对高危人群实施协同预防措施。本报告展示了使用新的 CDC 定义进行公共卫生监测和研究的模型程序。此类发现可用于向家长和提供者提供关于 AHT 的信息（例如，摇晃的危险，管理婴儿哭闹的策略），并更好地监测随着时间的推移预防策略的影响。
