To our knowledge, there are no recent national epidemiological studies in France on abusive head trauma (AHT). The objective of this study was to quantify cases of AHT as a result of child abuse admitted to French hospitals, based on the French hospital discharge database (PMSI) from 2015 to 2017. Among infants aged between one and 11 months who were hospitalised for subdural haematoma or traumatic subarachnoid haemorrhage, we distinguished probable cases (stays with International Statistical Classification of Diseases and Related Health Problems, 10^th Revision codes suggestive of child abuse or retinal haemorrhage) from possible cases (all other children), in order to make comparisons and estimate hospital incidence rates. We identified 512 probable cases and 703 possible cases. The incidence was 22.1 cases (20.2–24.0) per 100 000 live births for probable cases, and 52.4 cases (49.5–55.4) per 100 000 live births for combined probable and possible cases. The overall median age was four months with a male predominance. Among probable cases, lesions suggestive of abuse were more frequent, and there were fewer skull fractures and accidental falls than in possible cases. This exploratory analysis shows that it is complicated to determine precisely the number of cases of AHT from PMSI data. The implementation of a specific code for AHT in this database would identify these cases more accurately.

中文翻译：

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2015年至2017年在法国住院的虐待性头部创伤的婴儿受害者的鉴定

据我们所知，法国目前还没有关于虐待性头部创伤（AHT）的国家流行病学研究。这项研究的目的是基于2015年至2017年法国出院数据库（PMSI），对因入院虐待儿童而导致的AHT病例进行量化。在硬膜下住院的1至11个月大的婴儿中血肿或创伤性蛛网膜下腔出血，我们对可能的病例进行了区分（住院病史和相关健康问题的国际统计分类，^第10期修订代码建议从可能的情况（所有其他儿童）中虐待儿童或视网膜出血，以便进行比较并估计医院的发病率。我们确定了512个可能的案例和703个可能的案例。可能的病例中，每十万活产儿中有22.1例（20.2–24.0），每十万个活产儿中有52.4例（49.5–55.4）中。总体中位年龄为四个月，男性居多。在可能的病例中，比起可能的病例，提示滥用的病变更为常见，颅骨骨折和意外跌倒的发生率更低。这种探索性分析表明，从PMSI数据中准确确定AHT病例数很复杂。在此数据库中实施AHT的特定代码将更准确地识别这些情况。