Trends in Shaken Baby Syndrome Diagnoses Among Young Children Hospitalized for Abuse
Date
2020
Journal Title
Journal ISSN
Volume Title
Publisher
Research Square
Abstract
Objective To investigate national trends of SBS diagnosis codes and how trends varied among patient
and hospital characteristics.
Methods We examined possible SBS, conrmed SBS, total SBS, and non-SBS abuse diagnoses among
children age three and younger who were hospitalized for abuse between 1998 and 2014 using a
secondary analysis of the National Inpatient Sample, the largest US all-payer inpatient care database (N =
66,854). A baseline category logit model was used based on a quasi-likelihood approach (QIC) with an
independent working correlation structure.
Results The rate (per 100,000 census population) of total SBS diagnoses was 5.4 (± 0.3) between 1998
and 2014, whereas the rate of non-SBS abuse was 19.6 (± 1.0).The rate of conrmed SBS diagnoses
increased from 3.8 (± 0.3) in 1998 to 5.1 (± 0.9) in 2005, and decreased to 1.3 (± 0.2) in 2014. Possible
SBS diagnoses were 0.6 (± 0.2) in 1998, increasing to 2.4 (± 0.4) in 2014. Conrmed SBS diagnoses have
declined since 2002, while possible SBS diagnoses have increased. All abuse types were more frequent
among infants, males, children from low-income homes, and urban teaching hospitals.
Conclusions We investigated seventeen-year trends of SBS diagnoses among young children hospitalized
for abuse. The discrepancy between trends in possible and conrmed SBS suggests differences in norms
for diagnosing SBS, which has implications for which cases are considered AHT. Future research should
investigate diagnostic processes for SBS and whether all codes associated with abusive head injuries in
young children are classied as AHT. Our ndings also highlight the relativity dening and diagnosing
SBS. Medical professionals nd utility in diagnosing SBS, though may be more apt to apply possible SBS
diagnoses to abusive head injuries in children. Clarifying norms for SBS diagnosis and rening
denitions for AHT will ensure that young children presenting with abusive head injuries are included in
overall counts of AHT. This baseline data, an essential component of child abuse surveillance, will enable
ongoing efforts to track, prevent, and reduce child abuse
Description
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Article
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Keywords
child abuse, abusive head trauma, shaken baby syndrome, research, trends, secondary data
Citation
Conrad, A., Butcher, B., Oral, R., Ronnenberg, M., & Peek-Asa, C. (2020). Trends in Shaken Baby Syndrome Diagnoses Among Young Children Hospitalized for Abuse.