Abusive head trauma among children in Alaska: a population-based assessment

Figures & data

Table I CDC ICD-9-CM and ICD-10-CM coding. AHT cases must have both a clinical diagnosis AND injury/abuse code

AHT categorization	Clinical diagnosis code	Injury or abuse code
ICD-9 coding
Definite or presumptive abusive head trauma	781.0–781.4, 781.8, 800, 801, 803, 804.1–804.4, 804.6–804.9, 850, 851, 852.0–852.5, 853.0, 853.1, 854.0, 854.1, 925.1, 950.0–950.3, 959.01, 995.55**	E960.0, E967, E968.1, E968.2, E968.8, E968.9, 995.50* 995.54, 995.59*
Probable abusive head trauma	All of those above (except 995.55)	E987, E988.8, E988.9
ICD-10 coding
Definite or presumptive abusive head trauma	S02, S02.0–SO2.1, S02.7–S02.9, S04.0, S06.0–S06.9, S07.1, S07.8–S07.9, S09.7–S09.9, T90.2,T90.5,T90.8–T90.9	Y00, Y01, Y04, Y07.7–Y07.3, Y07.8–Y07.9, Y08, Y09, Y87.1, T74.1, T74.8–T74.9
Probable abusive head trauma	All of those above	Y29, Y30, Y33, Y34, Y87.2

*Exclude cases in the presence of a fall or accident code.

**Does not require injury or abuse code.

Fig. 1 Abusive head trauma rates 2005–2010 in children <2 years of age, Alaska.

Table II Abusive head trauma characteristics among children <2 years of age in Alaska, 2005–2010

Characteristic	Population*	AHT cases (%)	Incident rate (95% CI)†	Incidence rate ratio (95% CI)	p-Value±
Total	130,683	45	34.43 (25.12, 46.08)
Infant characteristics
Age
1 year	64,561	8 (18)	12.39 (5.35, 24.42)	1
< 1 year	66,122	37 (82)	55.96 (39.40, 77.13)	4.44 (2.18, 10.36)	<0.001
Missing		0
Sex
Male	67,514	20 (44)	29.62 (18.09, 45.75)	1
Female	63,169	25 (56)	39.56 (25.61, 58.42)	1.33 (0.74, 2.44)	0.338
Missing		0
Race
White	79,989	20 (44)	25.00 (15.27, 38.62)	1
Alaska Native	33,240	11 (24)	33.09 (16.52, 59.21)	1.33 (0.61, 2.75)	0.455
Asian/Pacific Island	10,445	8 (18)	76.59 (33.09, 150.92)	3.10 (1.27, 6.83)	0.015
Other	7,009	6 (13)	85.60 (31.42, 186.32)	3.49 (1.26, 8.25)	0.019
Missing		0
Maternal characteristics
Maternal age
<20	12,982	14 (31)	107.84 (58.96, 180.94)	1
20–29	75,775	23 (51)	30.35 (19.24, 45.54)	0.28 (0.15, 0.56)	<0.001
30 +	41,896	2 (4)	4.77 (0.58,17.24)	0.05 (0.01,0.17)	<0.001
Missing		6 (13)
Marital status
Married	82,205	12 (27)	14.58 (7.54, 25.50)	1
Unmarried	48,275	29 (64)	59.88 (40.11, 86.00)	4.07 (2.12, 8.33)	<0.001
Missing		4 (9)
Maternal education
12+ years	112,748	24 (53)	21.29 (13.64, 31.67)	1
< 12 years	17,703	13 (29)	73.43 (39.10, 125.57)	3.47 (1.71, 6.73)	0.001
Missing		8 (18)

*Population=[annual births+(previous year's births–previous year's infant deaths)].

†Incident rates per 100,000 children <2 years.

±p-Value and 95% CI's calculated by median unbiased estimation exact methods.

Fig. 2 Abusive head trauma detection by source.