• Brittany D Fraser, P Ryan Lingo, Nickalus R Khan, Brandy N Vaughn, and Paul Klimo.
• College of Medicine, University of Tennessee Health Science Center, Memphis, Tennessee.
• Neurosurgery. 2019 Jul 1; 85 (1): E66-E74.

BackgroundAbusive head trauma (AHT) may result in costly, long-term sequelae.ObjectiveTo describe the burden of AHT on the hospital system within the first year of injury.MethodsSingle 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.ResultsA 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.ConclusionAHT 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.Copyright © 2018 by the Congress of Neurological Surgeons.

21 keywords...

hide…