Pediatric Abusive Head Trauma

Return to Hospital System in the First Year Post Injury

Brittany D. Fraser, P. Ryan Lingo, Nickalus R. Khan, Brandy N. Vaughn, Paul Klimo

Research output: Contribution to journalArticle

Abstract

Abusive head trauma (AHT) may result in costly, long-term sequelae. OBJECTIVE: To describe the burden of AHT on the hospital system within the first year of injury. METHODS: Single institution retrospective evaluation of AHT cases from January 2009 to August 2016. Demographic, clinical (including injury severity graded I-III), and charge data associated with both initial and return hospital visits within 1 yr of injury were extracted. RESULTS: A total of 278 cases of AHT were identified: 60% male, 76% infant, and 54% African-American. Of these 278 cases, 162 (60%) returned to the hospital within the first year, resulting in 676 total visits (an average of 4.2 returns/patient). Grade I injuries were less likely to return than more serious injuries (II and III). The majority were outpatient services (n = 430, 64%); of the inpatient readmissions, neurosurgery was the most likely service to be involved (44%). Neurosurgical procedures accounted for the majority of surgeries performed during both initial admission and readmission (85% and 68%, respectively). Increasing injury severity positively correlated with charges for both the initial admission and returns (P <. 001 for both). Total calculated charges, including initial admission and returns, were over $25 million USD. CONCLUSION: AHT has a high potential for return to the hospital system within the first year. Inpatient charges dominate and account for the vast majority of hospital returns and overall charges. A more severe initial injury correlates with increased charges on initial admission and on subsequent hospital return.

Original languageEnglish (US)
Article numbernyy456
Pages (from-to)E66-E74
JournalClinical Neurosurgery
Volume85
Issue number1
DOIs
StatePublished - Jul 1 2019

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Craniocerebral Trauma
Pediatrics
Wounds and Injuries
Inpatients
Neurosurgical Procedures
Neurosurgery
Ambulatory Care
African Americans
Demography

All Science Journal Classification (ASJC) codes

  • Surgery
  • Clinical Neurology

Cite this

Pediatric Abusive Head Trauma : Return to Hospital System in the First Year Post Injury. / Fraser, Brittany D.; Lingo, P. Ryan; Khan, Nickalus R.; Vaughn, Brandy N.; Klimo, Paul.

In: Clinical Neurosurgery, Vol. 85, No. 1, nyy456, 01.07.2019, p. E66-E74.

Research output: Contribution to journalArticle

Fraser, Brittany D. ; Lingo, P. Ryan ; Khan, Nickalus R. ; Vaughn, Brandy N. ; Klimo, Paul. / Pediatric Abusive Head Trauma : Return to Hospital System in the First Year Post Injury. In: Clinical Neurosurgery. 2019 ; Vol. 85, No. 1. pp. E66-E74.
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