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Nonfatal traumatic brain injury-related hospitalization in very young children-15 states, 1999
Julie A Eisele1, Scott R Kegler, Roger B Trent
1Office of Statistics and Programming, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA 30341, USA.
Insights
Traumatic brain injury (TBI) hospitalizations in children under two peak in the first months of life, primarily due to falls and assaults. Prevention efforts should target these causes and the critical early infancy period.
Area of Science:
- Pediatric Traumatology
- Public Health Surveillance
- Injury Prevention
Background:
- Traumatic brain injury (TBI) is a significant cause of morbidity and mortality in children.
- Understanding age-related hospitalization patterns is crucial for targeted prevention strategies.
- Nonfatal TBI hospitalizations in infants and toddlers represent a substantial public health burden.
Purpose of the Study:
- To document age-related patterns of nonfatal hospitalizations associated with traumatic brain injury (TBI) in children younger than 2 years.
- To analyze these patterns by intent/cause (e.g., falls, assaults) and diagnosis.
- To identify critical age periods and injury mechanisms for focused prevention.
Main Methods:
- Utilized data from the Centers for Disease Control and Prevention (CDC) Central Nervous System Injury surveillance system.
- Analyzed 2536 nonfatal TBI-related hospitalizations in children aged 0-23 months from 15 states in 1999.
- Calculated incidence rates by integrating TBI surveillance data with US Census Bureau and National Center for Health Statistics population data.
Main Results:
- Overall nonfatal TBI hospitalization rates peaked at 1 month (178.0/100,000 person-years) and showed a secondary peak at 8 months (127.9/100,000 person-years).
- Fall-related and assault-related TBI rates were significantly higher in infants (0-11 months) compared to 1-year-olds (12-23 months), peaking early in infancy.
- Diagnoses of skull fracture and/or intracranial injury were more common in younger infants, with assaults frequently coinciding with intracranial injury.
Conclusions:
- Prevention strategies for TBI in early childhood should prioritize addressing falls and assaults.
- Emphasis on prevention during the first few months of life is critical due to the elevated risk.
- Targeted interventions focusing on high-risk periods and mechanisms can reduce TBI-related hospitalizations in young children.
Objective:
To document age-related patterns of nonfatal hospitalization associated with traumatic brain injury (TBI) among children younger than 2 years of age, by intent/cause and diagnosis.
Methods:
Data describing 2536 nonfatal TBI-related hospitalizations in 15 states for the year 1999 were obtained from the Centers for Disease Control and Prevention Central Nervous System Injury surveillance system for children younger than 2 years of age (0-23 months) at the time of injury.
Main Outcome Measures:
Incidence rates (overall, by intent/cause, and by diagnosis) were calculated by combining TBI surveillance data with population data from the US Census Bureau and the National Center for Health Statistics.
Results:
Overall rates of nonfatal TBI-related hospitalization peaked at 1 month of age (178.0 cases per 100,000 person-years) followed by a secondary peak at 8 months of age (127.9 cases per 100,000 person-years). Rates for fall-related (unintentional) cases and assault-related cases were significantly higher for infants (0-11 months) than for 1-year-olds (12-23 months), with rates for both types of cases peaking in the earliest months of life. Rates for cases with diagnoses of skull fracture and/or intracranial injury were also significantly higher for the younger group. Assault-related cases frequently coincided with a diagnosis of intracranial injury regardless of age.
Conclusions:
Prevention efforts should focus on falls and assaults, which account for the majority of TBI-related hospitalizations in early childhood. Such efforts may also need to emphasize the unusually high risk during the first few months of life.
