Long-term impact of abusive head trauma in young children: Outcomes at 5 and 11 years old

Background: Abusive head trauma (AHT) is a leading cause of morbidity and mortality among young children. We aimed to evaluate the long-term impact of AHT.

Methods: Using administrative claims from 2000-2018, children <3 years old with documented AHT who had follow-up through ages 5 and 11 years were identified. The primary outcome was incidence of neurodevelopmental disability and the secondary outcome was the effect of age at time of AHT on long-term outcomes.

Results: 1,165 children were identified with follow-up through age 5; 358 also had follow-up through age 11. The incidence of neurodevelopmental disability was 68.0% (792/1165) at 5 years of age and 81.6% (292/358) at 11 years of age. The incidence of disability significantly increased for the 358 children followed from 5 to 11 years old (+14.3 percentage points, p<0.0001). Children <1 year old at the time of AHT were more likely to develop disabilities when compared to 2 year olds.

Conclusions: AHT is associated with significant long-term disability by age 5 and the incidence increased by age 11 years. There is an association between age at time of AHT and long-term outcomes. Efforts to improve comprehensive follow-up as children continue to age is important.

Level of evidence: IV.