The Epidemiology of Pediatric Head Injury Treated Outside of Hospital Emergency Departments

Details

• Alternative Title:
  Epidemiology
• Personal Author:
  Zogg, Cheryl K. ; Haring, R. Sterling ; Xu, Likang ; Canner, Joseph K. ; AlSulaim, Hatim A. ; Hashmi, Zain G. ; Salim, Ali ; Engineer, Lilly D. ; Haider, Adil H. ; Bell, Jeneita M. ; Schneider, Eric B.
• Description:
  Background
  
  Although head trauma-related deaths, hospitalizations, and emergency department visits are well characterized, few studies describe pediatric patients presenting outside of emergency departments. We compared the epidemiology and extent of healthcare-seeking pediatric (0-17y) patients presenting in outpatient settings with those of patients seeking non-hospitalized emergency department care.
  
  Methods
  
  We used MarketScan Medicaid and commercial claims, 2004-2013, to identify patients managed in two outpatient settings (physician's offices/clinics, urgent care) and the emergency department. We then examined differences in demographic and injury-specific factors, CDC-defined head trauma diagnoses, the extent of and reasons for post-index visit ambulatory care use within 30/90/180 days, and annual and monthly variations in head trauma trends. Outpatient incidence rates in 2013 provided estimates of the nationwide US outpatient burden.
  
  Results
  
  A total of 1,683,097 index visits were included, representing a nationwide burden in 2013 of 844,660 outpatient cases, a number that encompassed 51% of healthcare-seeking head trauma that year and that substantially increased in magnitude from 2004-2013. Two-thirds (68%) were managed in outpatient settings. While demographic distributions varied with index-visit location, injury-specific factors were comparable. Seasonal spikes appeared to coincide with school sports.
  
  Conclusions
  
  There is an urgent need to better understand the natural history of head trauma in the >800,000 pediatric patients presenting each year for outpatient care. These outpatient injuries, which are more than double the number of head trauma cases recorded in hospital-affiliated settings, illustrate the potential importance of expanding inclusion criteria in surveillance and prevention efforts designed to address this critical issue.
  
  
• Subjects:
  Adolescent Child Child, Preschool Craniocerebral Trauma Databases, Factual Emergency Medical Services Female Humans Infant Insurance Claim Review Male

  More +
• Source:
  Epidemiology. 29(2):269-279
• Pubmed ID:
  29240568
• Pubmed Central ID:
  PMC5937022
• Document Type:
  Journal Article
• Funding:
  CC999999/ImCDC/Intramural CDC HHS/United States ; T32 GM007205/GM/NIGMS NIH HHS/United States
• Place as Subject:
  United States
• Volume:
  29
• Issue:
  2
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:4f4cffbfd0a73cb3fc4548dce59dfed5013bfbe8f5e1618a362a9aac9bb7751e
• Download URL:
  https://stacks.cdc.gov/view/cdc/53821/cdc_53821_DS1.pdf
• File Type:
  [PDF - 801.26 KB ]