Xiang Joe, Shi Junxin, Wheeler Krista Kurz, Yeates Keith Owen, Taylor H Gerry, Smith Gary A
Center for Injury Research and Policy, The Research Institute at Nationwide Children's Hospital , Columbus, OH , USA .
Brain Inj. 2013;27(13-14):1555-61. doi: 10.3109/02699052.2013.831126. Epub 2013 Oct 8.
To study characteristics and outcomes of paediatric patients with abusive head trauma (AHT) treated in emergency departments.
Nationwide Emergency Department Sample (NEDS) data were analysed. The CDC recommended AHT definition was used to classify children ≤ 4 years with head trauma into AHT and non-AHT groups. Outcomes were compared between patients with AHT and patients with non-AHT. Logistic models were fitted to identify risk factors.
An estimated 10 773 paediatric patients with AHT were treated in EDs in 2006-2009. The average annual rate was 12.83 per 100 000 for children ≤ 4 years. Children < 1 year of age accounted for most AHT cases (60.6%) and males had a significantly higher AHT rate than females. Medicaid was the primary payer for 66.1% of AHT injuries and 40.3% of non-AHT injuries. The case mortality rate was 53.9 (95% CI = 41.0-66.7) per 1000 patients with AHT compared with 1.6 (95% CI = 1.4-1.9) per 1000 patients with non-AHT.
Child caregivers should be educated about the serious consequences of AHT and proper techniques for caring for infants. Unbiased and accurate documentation of AHT by physicians and medical coders is crucial for monitoring AHT injuries.
研究在急诊科接受治疗的虐待性头部创伤（AHT）儿科患者的特征及治疗结果。
分析全国急诊科样本（NEDS）数据。采用美国疾病控制与预防中心（CDC）推荐的AHT定义，将4岁及以下头部创伤儿童分为AHT组和非AHT组。比较AHT患者与非AHT患者的治疗结果。采用逻辑模型确定危险因素。
2006 - 2009年估计有10773名患有AHT的儿科患者在急诊科接受治疗。4岁及以下儿童的年均发病率为每10万人12.83例。1岁以下儿童占大多数AHT病例（60.6%），男性的AHT发病率显著高于女性。医疗补助是66.1%的AHT损伤和40.3%的非AHT损伤的主要支付方。每1000例AHT患者的病例死亡率为53.9（95%CI = 41.0 - 66.7），而每1000例非AHT患者的病例死亡率为1.6（95%CI = 1.4 - 1.9）。
应向儿童看护者宣传AHT的严重后果以及照顾婴儿的正确方法。医生和医疗编码人员对AHT进行无偏见且准确的记录对于监测AHT损伤至关重要。
