Transcription of PEDIATRIC ABUSIVE HEAD TRAUMA
1 PEDIATRIC ABUSIVE HEAD TRAUMA RECOMMENDED DEFINITIONS FOR PUBLIC HEALTH SURVEILLANCE AND RESEARCHN ational Center for Injury Prevention and ControlDivision of Violence PreventionNational Center for Injury Prevention and Control Division of Violence PreventionPediatric ABUSIVE Head TRAUMA : Recommended Definitions for Public Health Surveillance and ResearchSharyn E. Parks, PhD, MPH Joseph L. Annest, PhD, MS Holly A. Hill, MD, PhD Debra L. Karch, PhDApril 2012 Centers for Disease Control and Prevention National Center for Injury Prevention and Control Division of Violence Prevention Atlanta, GeorgiaPediatric ABUSIVE Head TRAUMA : Recommended Definitions for Public Health Surveillance and Research is a publication of the National Center for Injury Prevention and Control of the Centers for Disease Control and for Disease Control and Prevention Thomas R.
2 Frieden, MD, MPH, DirectorNational Center for Injury Prevention and Control Linda C. Degutis, DrPH, MSN, DirectorDivision of Violence Prevention Howard R. Spivak, MD, DirectorSuggested Citation: Parks SE, Annest JL, Hill HA, Karch DL. PEDIATRIC ABUSIVE Head TRAUMA : Recommended Definitions for Public Health Surveillance and Research. Atlanta (GA): Centers for Disease Control and Prevention; of ContentsI. Introduction .. 5II. Background .. 5 a. The problem of PEDIATRIC ABUSIVE head TRAUMA .. 5 b. Challenges to tracking the occurrence of PEDIATRIC ABUSIVE head TRAUMA .
3 6 c. Summary of challenges .. 7 III. Purpose.. 7IV. Development of recommended definition of PEDIATRIC ABUSIVE head TRAUMA .. 8 a. Expert panel review process .. 8 b. Testing applicability of definition.. 8 1. Morbidity data sources .. 8 2. Mortality data sources.. 9V. CDC definition of PEDIATRIC ABUSIVE head TRAUMA ..10VI. Implementation of recommended definition ..10 a. Applicability of definition ..11 1. Nonfatal data sources..11 i. Hospital Emergency Department Data..11 ii. Hospital Inpatient Discharge Data ..11 2. Fatal data sources..12 i. Vital Statistics.
4 12 b. Data Analyses ..12 1. Application of CDC s operational AHT definition to morbidity data..12 2. Application of CDC s operational AHT definition to mortality data ..13 c. Conclusion ..14 VII. Figure 1. ICD-9-CM and External cause of injury codes for defining nonfatal ABUSIVE head TRAUMA in children < 5 years of age ..15 VIII. Figure 2. ICD-10 codes for defining fatal ABUSIVE head TRAUMA in children < 5 years of age ..16IX. References..17X. Appendices ..214 PEDIATRIC ABUSIVE HEAD TRAUMA : RECOMMENDED DEFINITIONS FOR PUBLIC HEALTH SURVEILLANCE AND RESEARCH5 PEDIATRIC ABUSIVE HEAD TRAUMA : RECOMMENDED DEFINITIONS FOR PUBLIC HEALTH SURVEILLANCE AND RESEARCHI.
5 IntroductionThe mission of the Centers for Disease Control and Prevention is to create the expertise, information, and tools that people and communities need to protect their health through health promotion, prevention of disease, injury and disability, and preparedness for new health threats (Centers for Disease Control and Prevention 2010). Among the key objectives used to achieve this mission is working with national and international partners to monitor health and detect and investigate health problems. Monitoring of population health is achieved through public health surveillance, defined as the ongoing and systematic collection, analysis, and interpretation of outcome-specific data for use in the planning, implementation, and evaluation of public health practice (Thacker and Berkelman 1988).
6 Public health surveillance relies on uniform case definitions and data elements that facilitate the collection of data useful for monitoring trends over time and characterizing persons at risk for health outcomes of interest among different subpopulations or geographic prevention of child maltreatment and the reduction of ABUSIVE injuries and their consequences is an important priority area for CDC. As part of the public health approach in addressing child maltreatment, CDC has launched an effort to develop uniform case definitions and data elements for use in surveillance of child maltreatment and ABUSIVE head TRAUMA .
7 In 2008, CDC published Version of Child Maltreatment Surveillance: Uniform Definitions for Public Health and Recommended Data Elements (Leeb et al. 2008), which covers all types of child maltreatment. The current report focuses on standard data elements for ABUSIVE head TRAUMA a specific category of child maltreatment that presents unique definitional and measurement challenges. These challenges are discussed followed by a presentation of recommended uniform operational definitions of fatal and nonfatal ABUSIVE head TRAUMA based on International Classification of Diseases (ICD-9-CM for morbidity coding and ICD-10 for mortality coding) diagnosis and external- cause-of-injury codes (2001; 2005).
8 Similar processes and formats to that of the Child Maltreatment Surveillance Uniform Definitions and Data Elements have been used in order to maintain consistency and facilitate ease of BackgroundA. The Problem of ABUSIVE Head TRAUMA in ChildrenSerious traumatic brain injury in young children is largely the result of abuse and results in significant morbidity and mortality (Administration for Children & Families ; National MCH Center for Child Death Review ; Bruce and Zimmerman 1989; Keenan et al. 2003). Among United States children, abuse is the third leading cause of all head injuries, after falls and motor vehicle crashes (Centers for Disease Control and Prevention 1997; Bishop 2006).
9 For children in the first year of life, the majority of serious head injuries result from abuse (Alexander, Levitt and Smith 2001). Estimates of the incidence of ABUSIVE head TRAUMA vary, but most range from 20 to 30 cases per 100,000 children under 1 year of age (Jayawant et al. 1998; Keenan et al. 2003; Barlow et al. 2005; Eisele et al. 2006; Ellingson, Leventhal and Weiss 2008). The incidence rate has been observed to decrease with increasing age (Keenan et al. 2003; Eisele et al. 2006; Duhaime 2008) with substantially higher incidence among those 1 year of age and younger (Agran et al.)
10 2003). The peak incidence and rapid decrease with age are thought to be related to episodes of prolonged, inconsolable, and unpredictable crying that are developmentally normal for infants (Catherine, Ko and Barr 2008; Barr 2009). 6 PEDIATRIC ABUSIVE HEAD TRAUMA : RECOMMENDED DEFINITIONS FOR PUBLIC HEALTH SURVEILLANCE AND RESEARCHE pisodes of crying that can trigger shaking behavior among parents and caregivers are known to increase in the first month after birth, peak in the second month, and decrease thereafter. (Barr 1990; Barr 2000; Barr 2006; Barr 2006; Lee et al. 2007).
