AI Article Synopsis
- The study investigates intentional head injuries (HIs) in children under 18, focusing on the demographics, types of perpetrators, and severity of these injuries across multiple emergency departments in Australia and New Zealand.
- Out of over 20,000 head-injured children, only 1.8% had intentional injuries, primarily inflicted by caregivers and peers, with 75.7% of caregiver assaults targeting children under two years old.
- Caregiver-inflicted injuries had the highest severity, with a significant rate of clinically important traumatic brain injury (ciTBI) at 22.3%, whereas injuries from peers and other assailants were less severe.
Article Abstract
Objective: Although there is a large body of research on head injury (HI) inflicted by caregivers in young children, little is known about intentional HI in older children and inflicted HI by perpetrators other than carers. Therefore, we set out to describe epidemiology, demographics and severity of intentional HIs in childhood.
Methods: A planned secondary analysis of a prospective multicentre cohort study was conducted in 10 EDs in Australia and New Zealand, including children aged <18 years with HIs. Epidemiology codes were used to prospectively code the injuries. Demographic and clinical information including the rate of clinically important traumatic brain injury (ciTBI: HI leading to death, neurosurgery, intubation >1 day or admission ≥2 days with abnormal computed tomography [CT]) was descriptively analysed.
Results: Intentional injuries were identified in 372 of 20 137 (1.8%) head-injured children. Injuries were caused by caregivers (103, 27.7%), by peers (97, 26.1%), by siblings (47, 12.6%), by strangers (35, 9.4%), by persons with unknown relation to the patient (21, 5.6%), other intentional injuries (8, 2.2%) or undetermined intent (61, 16.4%). About 75.7% of victims of assault by caregivers were <2 years, whereas in other categories, only 4.9% were <2 years. Overall, 66.9% of victims were male. Rates of CT performance and abnormal CT varied: assault by caregivers 68.9%/47.6%, by peers 18.6%/27.8%, by strangers 37.1%/5.7%. ciTBI rate was 22.3% in assault by caregivers, 3.1% when caused by peers and 0.0% with other perpetrators.
Conclusions: Intentional HI is infrequent in children. The most frequently identified perpetrators are caregivers and peers. Caregiver injuries are particularly severe.
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| http://dx.doi.org/10.1111/1742-6723.13202 | DOI Listing |
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