Abusive head trauma among children in Alaska: a population-based assessment
Background. Serious physical abuse resulting in a traumatic brain injury (TBI) has been implicated as an underreported cause of infant mortality. Nearly 80% of all abusive head trauma (AHT) occurs among children <2 years of age, with infants experiencing an incidence nearly 8 times that o...
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ftdoajarticles:oai:doaj.org/article:c5537727ac0847ea8a2f3f31bc1558f8 2023-05-15T15:15:50+02:00 Abusive head trauma among children in Alaska: a population-based assessment Jared Parrish Cathy Baldwin-Johnson Margaret Volz Yvonne Goldsmith 2013-08-01T00:00:00Z https://doi.org/10.3402/ijch.v72i0.21216 https://doaj.org/article/c5537727ac0847ea8a2f3f31bc1558f8 EN eng Taylor & Francis Group http://www.circumpolarhealthjournal.net/index.php/ijch/article/download/21216/pdf_1 https://doaj.org/toc/2242-3982 doi:10.3402/ijch.v72i0.21216 2242-3982 https://doaj.org/article/c5537727ac0847ea8a2f3f31bc1558f8 International Journal of Circumpolar Health, Vol 72, Iss 0, Pp 1-8 (2013) child maltreatment child abuse abusive head trauma traumatic brain injury surveillance epidemiology Arctic medicine. Tropical medicine RC955-962 article 2013 ftdoajarticles https://doi.org/10.3402/ijch.v72i0.21216 2022-12-30T22:14:01Z Background. Serious physical abuse resulting in a traumatic brain injury (TBI) has been implicated as an underreported cause of infant mortality. Nearly 80% of all abusive head trauma (AHT) occurs among children <2 years of age, with infants experiencing an incidence nearly 8 times that of 2-year olds. Objective. This study describes the validation of the CDC Pediatric Abusive Head Trauma (PAHT) definitions when applied to a multi-source database at the state level and provides a robust annual incidence estimate of AHT among children <2 years of age in Alaska. Design. AHT cases among children residing in Alaska during 2005–2010 were identified by applying the PAHT coding schema to a multi-source database which included vital death records, the Violent Death Reporting System (AK-VDRS), the Maternal Infant Mortality Review – Child Death Review (MIMR-CDR), the Alaska Trauma Registry (ATR), the inpatient Hospital Discharge Database (HDD) and Medicaid claims. Using these data, we calculated statewide AHT annual incidence rates. Results. The databases with the highest case capture rates were the ATR and Medicaid systems, both at 51%, followed by HDD at 38%. Combined, the ATR, HDD and Medicaid systems captured 91% of all AHT cases. The linkage and use of the PAHT definitions yielded an estimated sensitivity of 91% and specificity of 98%. During the study period, we detected an annual average incidence of 34.4 cases per 100,000 children aged <2 years (95% CI 25.1, 46.1) and a case fatality proportion of 22% (10/45). Among the AHT cases, 82% were infants. Significant differences (p < 0.05) in AHT were noted by age and race, but not by sex. Conclusions. In Alaska, applying the CDC PAHT definition to the multi-source database enabled us to capture 49% more AHT cases than any of the individual database used in this analysis alone. Article in Journal/Newspaper Arctic Circumpolar Health International Journal of Circumpolar Health Alaska Directory of Open Access Journals: DOAJ Articles Arctic International Journal of Circumpolar Health 72 1 21216 |
institution |
Open Polar |
collection |
Directory of Open Access Journals: DOAJ Articles |
op_collection_id |
ftdoajarticles |
language |
English |
topic |
child maltreatment child abuse abusive head trauma traumatic brain injury surveillance epidemiology Arctic medicine. Tropical medicine RC955-962 |
spellingShingle |
child maltreatment child abuse abusive head trauma traumatic brain injury surveillance epidemiology Arctic medicine. Tropical medicine RC955-962 Jared Parrish Cathy Baldwin-Johnson Margaret Volz Yvonne Goldsmith Abusive head trauma among children in Alaska: a population-based assessment |
topic_facet |
child maltreatment child abuse abusive head trauma traumatic brain injury surveillance epidemiology Arctic medicine. Tropical medicine RC955-962 |
description |
Background. Serious physical abuse resulting in a traumatic brain injury (TBI) has been implicated as an underreported cause of infant mortality. Nearly 80% of all abusive head trauma (AHT) occurs among children <2 years of age, with infants experiencing an incidence nearly 8 times that of 2-year olds. Objective. This study describes the validation of the CDC Pediatric Abusive Head Trauma (PAHT) definitions when applied to a multi-source database at the state level and provides a robust annual incidence estimate of AHT among children <2 years of age in Alaska. Design. AHT cases among children residing in Alaska during 2005–2010 were identified by applying the PAHT coding schema to a multi-source database which included vital death records, the Violent Death Reporting System (AK-VDRS), the Maternal Infant Mortality Review – Child Death Review (MIMR-CDR), the Alaska Trauma Registry (ATR), the inpatient Hospital Discharge Database (HDD) and Medicaid claims. Using these data, we calculated statewide AHT annual incidence rates. Results. The databases with the highest case capture rates were the ATR and Medicaid systems, both at 51%, followed by HDD at 38%. Combined, the ATR, HDD and Medicaid systems captured 91% of all AHT cases. The linkage and use of the PAHT definitions yielded an estimated sensitivity of 91% and specificity of 98%. During the study period, we detected an annual average incidence of 34.4 cases per 100,000 children aged <2 years (95% CI 25.1, 46.1) and a case fatality proportion of 22% (10/45). Among the AHT cases, 82% were infants. Significant differences (p < 0.05) in AHT were noted by age and race, but not by sex. Conclusions. In Alaska, applying the CDC PAHT definition to the multi-source database enabled us to capture 49% more AHT cases than any of the individual database used in this analysis alone. |
format |
Article in Journal/Newspaper |
author |
Jared Parrish Cathy Baldwin-Johnson Margaret Volz Yvonne Goldsmith |
author_facet |
Jared Parrish Cathy Baldwin-Johnson Margaret Volz Yvonne Goldsmith |
author_sort |
Jared Parrish |
title |
Abusive head trauma among children in Alaska: a population-based assessment |
title_short |
Abusive head trauma among children in Alaska: a population-based assessment |
title_full |
Abusive head trauma among children in Alaska: a population-based assessment |
title_fullStr |
Abusive head trauma among children in Alaska: a population-based assessment |
title_full_unstemmed |
Abusive head trauma among children in Alaska: a population-based assessment |
title_sort |
abusive head trauma among children in alaska: a population-based assessment |
publisher |
Taylor & Francis Group |
publishDate |
2013 |
url |
https://doi.org/10.3402/ijch.v72i0.21216 https://doaj.org/article/c5537727ac0847ea8a2f3f31bc1558f8 |
geographic |
Arctic |
geographic_facet |
Arctic |
genre |
Arctic Circumpolar Health International Journal of Circumpolar Health Alaska |
genre_facet |
Arctic Circumpolar Health International Journal of Circumpolar Health Alaska |
op_source |
International Journal of Circumpolar Health, Vol 72, Iss 0, Pp 1-8 (2013) |
op_relation |
http://www.circumpolarhealthjournal.net/index.php/ijch/article/download/21216/pdf_1 https://doaj.org/toc/2242-3982 doi:10.3402/ijch.v72i0.21216 2242-3982 https://doaj.org/article/c5537727ac0847ea8a2f3f31bc1558f8 |
op_doi |
https://doi.org/10.3402/ijch.v72i0.21216 |
container_title |
International Journal of Circumpolar Health |
container_volume |
72 |
container_issue |
1 |
container_start_page |
21216 |
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1766346170926366720 |