Related Experiment Video
Updated: May 8, 2026
Assessing Changes in Synaptic Plasticity Using an Awake Closed-Head Injury Model of Mild Traumatic Brain Injury
Published on: January 20, 2023
Abusive head trauma among children in Alaska: a population-based assessment
Jared Parrish1, Cathy Baldwin-Johnson, Margaret Volz
1MCH-Epidemiology Unit, Alaska Division of Public Health, Anchorage, AK, USA. jwp22@live.unc.edu
Insights
Abusive head trauma (AHT) is a significant cause of infant mortality. This study validated the CDC Pediatric Abusive Head Trauma (PAHT) definitions in Alaska, revealing an annual incidence of 34.4 cases per 100,000 children under two.
Area of Science:
- Pediatric Trauma
- Public Health Surveillance
- Child Abuse and Neglect
Background:
- Serious physical abuse leading to traumatic brain injury (TBI) is an underreported cause of infant mortality.
- Abusive head trauma (AHT) predominantly affects children under two years old, with infants being at the highest risk.
Purpose of the Study:
- To validate the Centers for Disease Control and Prevention's (CDC) Pediatric Abusive Head Trauma (PAHT) definitions using a multi-source state-level database.
- To establish a robust annual incidence estimate for AHT in children under two years of age in Alaska.
Main Methods:
- Applied the PAHT coding schema to a comprehensive multi-source database in Alaska from 2005-2010.
- Included vital death records, Violent Death Reporting System, Child Death Review, Alaska Trauma Registry, Hospital Discharge Database, and Medicaid claims.
- Calculated statewide annual AHT incidence rates using linked data.
Main Results:
- The Alaska Trauma Registry and Medicaid systems demonstrated the highest case capture rates (51%).
- A combined approach using the Alaska Trauma Registry, Hospital Discharge Database, and Medicaid captured 91% of all AHT cases.
- The study estimated an annual AHT incidence of 34.4 per 100,000 children under two, with a 22% case fatality rate. Significant differences were observed by age and race.
Conclusions:
- Utilizing the CDC PAHT definition with a multi-source database in Alaska identified 49% more AHT cases compared to individual data sources.
- This validated approach enhances the accuracy of AHT surveillance and reporting in pediatric populations.
Background:
Serious physical abuse resulting in a traumatic brain injury (TBI) has been implicated as an underreported cause of infant mortality. Nearly 80% of all abusive head trauma (AHT) occurs among children <2 years of age, with infants experiencing an incidence nearly 8 times that of 2-year olds.
Objective:
This study describes the validation of the CDC Pediatric Abusive Head Trauma (PAHT) definitions when applied to a multi-source database at the state level and provides a robust annual incidence estimate of AHT among children <2 years of age in Alaska.
Design:
AHT cases among children residing in Alaska during 2005-2010 were identified by applying the PAHT coding schema to a multi-source database which included vital death records, the Violent Death Reporting System (AK-VDRS), the Maternal Infant Mortality Review - Child Death Review (MIMR-CDR), the Alaska Trauma Registry (ATR), the inpatient Hospital Discharge Database (HDD) and Medicaid claims. Using these data, we calculated statewide AHT annual incidence rates.
Results:
The databases with the highest case capture rates were the ATR and Medicaid systems, both at 51%, followed by HDD at 38%. Combined, the ATR, HDD and Medicaid systems captured 91% of all AHT cases. The linkage and use of the PAHT definitions yielded an estimated sensitivity of 91% and specificity of 98%. During the study period, we detected an annual average incidence of 34.4 cases per 100,000 children aged <2 years (95% CI 25.1, 46.1) and a case fatality proportion of 22% (10/45). Among the AHT cases, 82% were infants. Significant differences (p < 0.05) in AHT were noted by age and race, but not by sex.
Conclusions:
In Alaska, applying the CDC PAHT definition to the multi-source database enabled us to capture 49% more AHT cases than any of the individual database used in this analysis alone.
More Related Videos
07:02An Investigation of the Effects of Sports-related Concussion in Youth Using Functional Magnetic Resonance Imaging and the Head Impact Telemetry System
Published on: January 12, 2011
07:01A Pediatric Concussion Model in Mice: Closed Head Injury with Long-Term Disorders (CHILD)
Published on: February 7, 2025
