Previous studies on Abusive Head Trauma (AHT) suggest incidence may vary by geographic location and there is limited information regarding population-based risk factors on this form of child maltreatment. This study provides new knowledge regarding these two aspects using the population of the US state of Washington born between 1999 and 2013. We used a linked administrative dataset comprised of birth, hospital discharge, child protective services (CPS) and death records to identify the scale and risk factors for AHT for the state population using quantitative survival methods. We identified AHT using diagnostic codes in hospital discharge records defined by the US Centers for Disease Control. A total of 354 AHT hospitalisations were identified and the incidence for the state was 22.8 per 100 000 children under the age of one. Over 11 per cent of these children died. Risk factors included a teenaged mother at the time of birth, births paid for using public insurance, child's low birth weight, and maternal Native American race. The strongest risk factor was a prior CPS allegation, a similar finding to a California study on injury mortality. The practice and policy implications of these findings are discussed.

中文翻译：

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虐待性头部创伤的发生率和危险因素：一项基于人群的研究


先前关于虐待性头部创伤（AHT）的研究表明，发病率可能因地理位置而异，并且有关这种形式的儿童虐待的基于人群的危险因素的信息有限。本研究使用 1999 年至 2013 年出生的美国华盛顿州人口提供了关于这两方面的新知识。我们使用由出生、出院、儿童保护服务 (CPS) 和死亡记录组成的关联管理数据集来确定规模使用定量生存方法对州人口进行 AHT 的危险因素。我们使用美国疾病控制中心定义的出院记录中的诊断代码来识别 AHT。总共确定了 354 例 AHT 住院病例，该州的发病率为每 10 万名 1 岁以下儿童中 22.8 例。其中超过 11% 的儿童死亡。风险因素包括分娩时母亲年幼、使用公共保险支付分娩费用、孩子出生体重过轻以及母亲是美洲原住民种族。最强的风险因素是之前的 CPS 指控，这与加州伤害死亡率研究的结果类似。讨论了这些发现的实践和政策含义。