Outcome of abusive head trauma in children less than 2 years: A single center study from a middle-income country

Ang SC 1 , Marret MJ 2 , Jayanath S 3 , Khoo WV 4 , Takwir MFM 5

Affiliations 

  • 1 Department of Paediatrics, University of Malaya, 50603 Kuala Lumpur, Malaysia. Electronic address: siewchen@ummc.edu.my
  • 2 Department of Paediatrics, University of Malaya, 50603 Kuala Lumpur, Malaysia; Department of Paediatrics, University of Malaya Medical Centre, 59100 Kuala Lumpur, Malaysia. Electronic address: marret@um.edu.my
  • 3 Department of Paediatrics, University of Malaya, 50603 Kuala Lumpur, Malaysia; Department of Paediatrics, University of Malaya Medical Centre, 59100 Kuala Lumpur, Malaysia. Electronic address: subhashinij@um.edu.my
  • 4 Department of Paediatrics, University of Malaya, 50603 Kuala Lumpur, Malaysia; Department of Paediatrics, University of Malaya Medical Centre, 59100 Kuala Lumpur, Malaysia. Electronic address: wvkhoo@ummc.edu.my
  • 5 Department of Paediatrics, University of Malaya Medical Centre, 59100 Kuala Lumpur, Malaysia. Electronic address: fawwazq@ummc.edu.my
Child Abuse Negl, 2021 Oct;120:105187.
PMID: 34218125 DOI: 10.1016/j.chiabu.2021.105187

Abstract

BACKGROUND: Abusive head trauma (AHT) is a severe manifestation of physical abuse in young children. This study examines the outcome of AHT in children under 2 years and features associated with mortality and disability.

METHODS: Retrospective chart review of 72 children under 2 years diagnosed to have AHT between 2011 and 2018 at a tertiary teaching hospital in Malaysia. Demographic variables, clinical features, results of neuroimaging and their associations with outcome were explored.

RESULTS: The median age at presentation was 4 months, 78% were six months or younger and 68% were male. Two-thirds became unwell in the care of an alternative caregiver. Subdural hemorrhage was present in 98%. Mortality was 10%. Forty-nine survivors returned with median interval of 16 months (IQR 5-44 months) between discharge and last follow-up. At least 35% of 65 survivors were disabled with 29% having multiple disabilities. Multiple disabilities (61.1% versus 25.8%) and cognitive impairment (61.1% versus 22.6%) were significantly higher in children 3 years or older at last follow-up (p 

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.

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