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Retention in a longitudinal multidisciplinary abusive head trauma clinic
Antonia Chiesa1, Ligia Batista1, Terri Lewis1
1Kempe Center for the Prevention and Treatment of Child Abuse and Neglect, Department of Pediatrics and Children's Hospital Colorado, University of Colorado Anschutz Medical Campus, 13123 E 16th Ave B138, Aurora, CO, 80045, USA.
High retention was observed in a multidisciplinary clinic for abusive head trauma (AHT) patients. Severe injuries and out-of-home placement were linked to increased follow-up visits, suggesting this model can improve AHT care.
Area of Science:
- Pediatric neurology
- Child abuse and neglect research
- Healthcare outcomes and services research
Background:
- Children with abusive head trauma (AHT) require long-term multidisciplinary care.
- Little is known about patient retention and factors influencing follow-up in AHT clinics.
- A comprehensive, multidisciplinary clinic was established to facilitate follow-up care for children with AHT.
Purpose of the Study:
- To describe patient retention in a specialized multidisciplinary clinic for AHT.
- To examine how injury characteristics and child placement outcomes correlate with retention metrics.
Main Methods:
- Data were collected from medical charts of children diagnosed with AHT between June 2011 and December 2020.
- Patient retention was assessed by the number of follow-up visits over 24 months.
- Multivariable regression analyzed associations between demographics, injury characteristics, placement, and clinic retention.
Main Results:
- Eighty percent of AHT survivors attended at least one follow-up visit, averaging 4.5 visits over 24 months.
- Severe injuries (subdural hemorrhage, parenchymal injuries), longer PICU stays, and out-of-home placement were associated with more visits.
- Younger children (under 24 months) had more follow-up visits than older children.
Conclusions:
- A multidisciplinary AHT clinic demonstrated high patient retention.
- Retention is associated with injury severity and out-of-home placement, highlighting the need for intensive follow-up.
- This care model shows promise for improving clinical management and outcomes research in AHT.
