Overlap Exists in TBI, Fractures Attributable to Abuse

Brain injury, fracture overlap found in those under 3; falls more common than abuse in those under 1
By Beth Gilbert
HealthDay Reporter

MONDAY, June 7 (HealthDay News) -- In children younger than 3, considerable overlap exists in the occurrence of traumatic brain injuries (TBIs) and fractures attributable to abuse, though accidental falls occur more commonly than abuse, even among very young children, according to a study published online June 7 in Pediatrics.

John M. Leventhal, M.D., of Yale University in New Haven, Conn., and colleagues compared abuse, accidental falls, other accidents, and motor vehicle accidents using the 2006 Kids' Inpatient Database to determine the incidence of abusive TBIs and/or fractures and the frequency of abuse versus accidents among children younger than 36 months of age.

The researchers found that the rate of fractures and/or TBIs attributable to abuse was 50 cases per 100,000 children younger than 12 months and 21.9 cases per 100,000 children younger than 36 months. They found that 29.9 percent of children in the abuse group had TBIs only, 28.3 percent experienced TBIs and fractures, and 41.8 percent had fractures only. For TBIs only, accidental falls were more common than abuse in the first two months of life, whereas abuse was more common from two to seven months. For skull fractures only, the researchers found almost all injuries were attributable to accidental falls, and falls were found more common during the first year of life for TBIs and skull fractures.

"Findings on the frequency of injuries attributable to abuse versus accidents in the first 36 months of life should be helpful for clinicians evaluating injuries in young children," the authors write.

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