Paediatric intentional head injuries in the emergency department: A multicentre prospective cohort study

Abstract

Background: While the majority of head injuries in children are non-intentional, there is limited information on intentional injuries outside abusive head trauma. Objective: To investigate intentional head injuries in terms of demographics, epidemiology and severity. Methods: Planned secondary analysis of prospective multicentre cohort study of children aged <18 years across 10 centres in Australia and New Zealand. Victorian state epidemiology codes (intent, activity, place, mechanism) were used to prospectively code the injuries. Data were descriptively analysed. Results: Intentional injuries were found in 441 of 20 137 (2.2%) head-injured children. Injuries were caused by peers (166, 37.6%), by caregiver (103, 23.4%), by sibling (47, 10.7%), due to attack by stranger (35, 7.9%), attack by person with unknown relation to patient (19, 4.3%), intentional self-harm (7, 1.6%), other cause or undetermined (64, 28.2%). Children were <2 years old in 75.7% injuries caused by caregivers and 8.3% in other causes. Overall, 71.0% of victims were male. Admission rates varied from 77.7% for assault by caregiver, 37.1% attack by stranger, 22.3% by peer and 8.5% by sibling. Peer assaults were related to sports in 69 cases (41.6%), with highest frequency in contact sports, rugby (40.6) and Australian football (26.1%). Conclusion: Intentional head injuries are infrequent in children. The most frequent cause is peer assault, often during sports, and injuries caused by caregivers.L6173527422017-07-21 <br />