{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T16:46:18Z","timestamp":1788453978990,"version":"build-2803163510"},"reference-count":21,"publisher":"American Academy of Pediatrics (AAP)","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2010,7,1]]},"abstract":"<jats:sec>\n                    <jats:title>OBJECTIVE:<\/jats:title>\n                    <jats:p>The goal was to use a national database to determine the incidence of abusive traumatic brain injuries (TBIs) and\/or fractures and the frequency of abuse versus accidents among children &amp;lt;36 months of age.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS:<\/jats:title>\n                    <jats:p>We used the 2006 Kids' Inpatient Database and classified cases into 3 types of injuries, that is, (1) TBI only, (2) TBI and fracture, or (3) fracture only. Groups 2 and 3 were divided into 3 patterns, that is, (1) skull fractures, (2) skull and nonskull fractures, or (3) nonskull fractures. For each type and pattern, we compared abuse, accidental falls, other accidents, and motor vehicle accidents.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS:<\/jats:title>\n                    <jats:p>The incidence of TBIs and\/or fractures attributable to abuse was 21.9 cases per 100 000 children &amp;lt;36 months of age and 50.0 cases per 100 000 children &amp;lt;12 months of age. In the abuse group, 29.9% of children had TBIs only, 28.3% TBIs and fractures, and 41.8% fractures only. Abused children were younger and were more likely to be enrolled in Medicaid. For TBI only, falls were more common than abuse in the first 2 months of life but abuse was more common from 2 to 7 months. For TBI and skull fracture, falls were more common during the first year of life. For skull fracture only, almost all injuries were attributable to falls.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS:<\/jats:title>\n                    <jats:p>There was overlap in TBIs and fractures attributable to abuse. Among &amp;lt;12-month-old children, TBIs and\/or fractures attributable to abuse occurred in 1 of 2000. Falls occurred more commonly than abuse, even among very young children.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1542\/peds.2009-1076","type":"journal-article","created":{"date-parts":[[2010,6,7]],"date-time":"2010-06-07T22:05:00Z","timestamp":1275948300000},"page":"e104-e115","source":"Crossref","is-referenced-by-count":76,"title":["Fractures and Traumatic Brain Injuries: Abuse Versus Accidents in a US Database of Hospitalized Children"],"prefix":"10.1542","volume":"126","author":[{"given":"John M.","family":"Leventhal","sequence":"first","affiliation":[{"name":"Departments of Pediatrics and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kimberly D.","family":"Martin","sequence":"additional","affiliation":[{"name":"Epidemiology and Public Health, School of Medicine, Yale University, New Haven, Connecticut"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea G.","family":"Asnes","sequence":"additional","affiliation":[{"name":"Departments of Pediatrics and"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"417","published-online":{"date-parts":[[2010,7,1]]},"reference":[{"issue":"3","key":"2021120819582040700_B1","doi-asserted-by":"crossref","first-page":"636","DOI":"10.1542\/peds.108.3.636","article-title":"The cause of infant and toddler subdural hemorrhage: a prospective study","volume":"108","author":"Feldman","year":"2001","journal-title":"Pediatrics"},{"issue":"5","key":"2021120819582040700_B2","first-page":"585","article-title":"Analysis of 429 fractures in 189 battered children","volume":"8","author":"King","year":"1988","journal-title":"J Pediatr Orthop"},{"issue":"1","key":"2021120819582040700_B3","doi-asserted-by":"crossref","first-page":"165","DOI":"10.1542\/peds.114.1.165","article-title":"Characteristics that distinguish accidental from abusive injury in hospitalized young children with head trauma","volume":"114","author":"Bechtel","year":"2004","journal-title":"Pediatrics"},{"issue":"1","key":"2021120819582040700_B4","doi-asserted-by":"crossref","first-page":"87","DOI":"10.1001\/archpedi.1993.02160250089028","article-title":"Fractures in young children: distinguishing child abuse from unintentional injuries","volume":"147","author":"Leventhal","year":"1993","journal-title":"Am J Dis Child"},{"issue":"5","key":"2021120819582040700_B5","doi-asserted-by":"crossref","first-page":"621","DOI":"10.1001\/jama.290.5.621","article-title":"A population-based study of inflicted traumatic brain injury in young children","volume":"290","author":"Keenan","year":"2003","journal-title":"JAMA"},{"issue":"7172","key":"2021120819582040700_B6","doi-asserted-by":"crossref","first-page":"1558","DOI":"10.1136\/bmj.317.7172.1558","article-title":"Subdural haemorrhages in infants: population based study","volume":"317","author":"Jayawant","year":"1998","journal-title":"BMJ"},{"key":"2021120819582040700_B7","doi-asserted-by":"crossref","first-page":"S157","DOI":"10.1016\/j.amepre.2007.12.021","article-title":"Using hospital discharge data to track inflicted traumatic brain injury","volume":"34","author":"Ellingson","year":"2008","journal-title":"Am J Prev Med"},{"issue":"3","key":"2021120819582040700_B8","doi-asserted-by":"crossref","first-page":"599","DOI":"10.1542\/peds.2007-1959","article-title":"Incidence of fractures attributable to abuse in young hospitalized children: results from analysis of a United States database","volume":"122","author":"Leventhal","year":"2008","journal-title":"Pediatrics"},{"issue":"3","key":"2021120819582040700_B9","doi-asserted-by":"crossref","DOI":"10.1542\/peds.108.3.e45","article-title":"Rates of pediatric and adolescent injuries by year of age","volume":"108","author":"Agran","year":"2001","journal-title":"Pediatrics"},{"issue":"6","key":"2021120819582040700_B10","doi-asserted-by":"crossref","DOI":"10.1542\/peds.111.6.e683","article-title":"Rates of pediatric injuries by 3-month intervals for children 0 to 3 years of age","volume":"111","author":"Agran","year":"2003","journal-title":"Pediatrics"},{"key":"2021120819582040700_B11","unstructured":"Agency for Healthcare Research and Quality. 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