Abstract
Background
Traumatic brain injury (TBI) is the leading cause of death and disability in young
children; however, the impact of mechanism on outcomes has not been fully evaluated.
We hypothesized that children with TBI due to abuse would have a higher mortality
than children with accidental TBI due to motor vehicle collisions (MVC).
Methods
We performed a retrospective review of the National Kids’ Inpatient (KID) hospitalizations
database of children <2 years old with TBI due to abuse or MVC (2000–2016). The primary
outcome was mortality. Secondary outcomes were length of stay (LOS) and hospital charges.
We investigated predictors of mortality with multivariable regression.
Results
Of 10,965 children with TBI, 65.2% were due to abuse. Overall mortality was 9.8% (n = 1074). Abused children had longer LOS (5.7 vs 1.6 days, p < 0.0001) and higher hospital charges ($34,314 vs $19,360, p < 0.0001) than children with TBI due to MVC. The odds of mortality were 42% higher
in children with abusive head trauma (OR 1.42, 95% CI 1.10–1.83, p = 0.007) compared to MVCs after adjusting for age, race, sex, neurosurgical intervention,
injury severity, and insurance.
Conclusion
Children with abusive traumatic brain injury have increased risk of mortality, longer
LOS, and higher hospital charges compared to children with TBI due to motor vehicle
collision after adjusting for relevant confounders. Resources must be directed at
prevention and early identification of abuse.
Keywords
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Article info
Publication history
Published online: February 24, 2021
Accepted:
February 5,
2021
Received:
January 14,
2021
Identification
Copyright
© 2021 Elsevier Inc. All rights reserved.
