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Journal Article

Citation

Fraser BD, Lingo PR, Khan NR, Vaughn BN, Klimo P. Neurosurgery 2019; 85(1): E66-E74.

Affiliation

Semmes Murphey, Memphis, Tennessee.

Copyright

(Copyright © 2019, Congress of Neurological Surgeons)

DOI

10.1093/neuros/nyy456

PMID

30476266

Abstract

BACKGROUND: Abusive head trauma (AHT) may result in costly, long-term sequelae.

OBJECTIVE: To describe the burden of AHT on the hospital system within the first year of injury.

METHODS: Single institution retrospective evaluation of AHT cases from January 2009 to August 2016. Demographic, clinical (including injury severity graded I-III), and charge data associated with both initial and return hospital visits within 1 yr of injury were extracted.

RESULTS: A total of 278 cases of AHT were identified: 60% male, 76% infant, and 54% African-American. Of these 278 cases, 162 (60%) returned to the hospital within the first year, resulting in 676 total visits (an average of 4.2 returns/patient). Grade I injuries were less likely to return than more serious injuries (II and III). The majority were outpatient services (n = 430, 64%); of the inpatient readmissions, neurosurgery was the most likely service to be involved (44%). Neurosurgical procedures accounted for the majority of surgeries performed during both initial admission and readmission (85% and 68%, respectively). Increasing injury severity positively correlated with charges for both the initial admission and returns (P < .001 for both). Total calculated charges, including initial admission and returns, were over $25 million USD.

CONCLUSION: AHT has a high potential for return to the hospital system within the first year. Inpatient charges dominate and account for the vast majority of hospital returns and overall charges. A more severe initial injury correlates with increased charges on initial admission and on subsequent hospital return.


Language: en

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