@article{ref1,
title="Abusive head trauma among children in Alaska: a population-based assessment",
journal="International journal of circumpolar health",
year="2013",
author="Parrish, Jared and Baldwin-Johnson, Cathy and Volz, Margaret and Goldsmith, Yvonne",
volume="72",
number="",
pages="21216-21216",
abstract="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.<p /> <p>Language: en</p>",
language="en",
issn="1239-9736",
doi="10.3402/ijch.v72i0.21216",
url="http://dx.doi.org/10.3402/ijch.v72i0.21216"
}