Nonfatal Traumatic Brain Injury–Related Hospitalization in Very Young Children—15 States, 1999

Objective 

To document age-related patterns of nonfatal hospitalization associated with traumatic brain injury (TBI) among children younger than 2 years of age, by intent/cause and diagnosis.

Methods 

Data describing 2536 nonfatal TBI-related hospitalizations in 15 states for the year 1999 were obtained from the Centers for Disease Control and Prevention Central Nervous System Injury surveillance system for children younger than 2 years of age (0–23 months) at the time of injury.

Main Outcome Measures 

Incidence rates (overall, by intent/cause, and by diagnosis) were calculated by combining TBI surveillance data with population data from the US Census Bureau and the National Center for Health Statistics.

Results 

Overall rates of nonfatal TBI-related hospitalization peaked at 1 month of age (178.0 cases per 100,000 person-years) followed by a secondary peak at 8 months of age (127.9 cases per 100,000 person-years). Rates for fall-related (unintentional) cases and assault-related cases were significantly higher for infants (0–11 months) than for 1-year-olds (12–23 months), with rates for both types of cases peaking in the earliest months of life. Rates for cases with diagnoses of skull fracture and/or intracranial injury were also significantly higher for the younger group. Assault-related cases frequently coincided with a diagnosis of intracranial injury regardless of age.

Conclusions 

Prevention efforts should focus on falls and assaults, which account for the majority of TBI-related hospitalizations in early childhood. Such efforts may also need to emphasize the unusually high risk during the first few months of life.