title: Head injury secondary to suspected child maltreatment: results of a prospective Canadian national surveillance program.
abstract: OBJECTIVE
  We sought to determine the incidence, clinical features, and demographic profile of head injury secondary to suspected child maltreatment (abuse or neglect) in Canada to help inform the development and evaluation of prevention programs for abusive head injuries.
  
  
  METHODS
  From March 1, 2005 to February 28, 2008, an average of 2,545 paediatricians and paediatric subspecialists were surveyed monthly through the established network of the Canadian Paediatric Surveillance Program. We calculated incidence rates using the number of confirmed cases over the product of the duration of the study (3 years) and population estimates by age group.
  
  
  RESULTS
  There were 220 confirmed cases of head injury from suspected child maltreatment. The annual incidence rate was 14.1 per 100,000 for children less than 1 year of age and 1.4 per 100,000 for those less than 15 years. Seventy three percent (141) of cases involved infants less than 12 months of age and 52% (100) of cases involved infants less than 6 months of age. Seventy-five percent (165) of cases presented to the emergency room. With regard to outcome, 12% (27) of cases resulted in death and 45% (75) of survivors had neurological sequelae at discharge. Thirty percent (67) of all cases, as well as 30% (8) of deaths were previously known to child welfare authorities.
  
  
  CONCLUSIONS
  This study provides an estimate of the rate of head injury secondary to suspected child maltreatment in Canada. The young age and poor medical outcomes of those involved highlights the need for prevention efforts that are implemented early in life. Given that a significant percentage of injured infants and children were already known to child welfare authorities, the study also highlights the need to establish and evaluate additional preventive efforts for parents and caregivers already in the child welfare system.
authors.affiliation: Department of Psychiatry, Children's Hospital of Eastern Ontario, University of Ottawa, ON, Canada K1H 8L1.
authors.forename: Susan
authors.initials: S
authors.lastname: Bennett
authors.forename: Michelle
authors.initials: M
authors.lastname: Ward
authors.forename: Katherine
authors.initials: K
authors.lastname: Moreau
authors.forename: Gilles
authors.initials: G
authors.lastname: Fortin
authors.forename: Jim
authors.initials: J
authors.lastname: King
authors.forename: Morag
authors.initials: M
authors.lastname: Mackay
authors.forename: Amy
authors.initials: A
authors.lastname: Plint
mesh_terms: D002170:Canada / Q000453:epidemiology; D002649:Child Abuse / Q000175:diagnosis / Q000706:statistics & numerical data; D002675:Child, Preschool; D006259:Craniocerebral Trauma / Q000175:diagnosis / Q000453:epidemiology; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D008297:Male; D011159:Population Surveillance; D011446:Prospective Studies; D012307:Risk Factors