title: Epidemiology of abusive abdominal trauma hospitalizations in United States children.
abstract: OBJECTIVE
  (1) To estimate the incidence of abusive abdominal trauma (AAT) hospitalizations among US children age 0-9 years. (2) To identify demographic characteristics of children at highest risk for AAT.
  
  
  METHODS
  Secondary data analysis of a cross-sectional, national hospitalization database.
  
  
  METHODS
  Hospitalization data from the 2003 and 2006 Kids' Inpatient Database (KID).
  
  
  METHODS
  Frequency and rate of hospitalizations for abusive abdominal trauma as identified by ICD-9CM codes for abdominal trauma and child abuse and E-codes for inflicted injury.
  
  
  METHODS
  Hospitalization rates by age, insurance status, and frequency of specific organ injury.
  
  
  RESULTS
  AAT rates were higher for infants than for any other age group, with 17.7 (95% CI 11.7-23.9) cases per million in 2006. More than 25% of all abdominal trauma in children <1 year of age was abusive. For all age groups, rates were higher for males than females, and for children insured by Medicaid compared to those with private insurance. Organs most commonly injured were the liver (64% of hospitalizations), kidney (19%), and stomach/intestines (12%).
  
  
  CONCLUSIONS
  Although experts have considered toddlers to be at highest risk for AAT, infants have higher rates of AAT hospitalization. Similar to other abusive injuries, young age, male gender, and poverty are risk factors for AAT.
authors.affiliation: Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, MD, USA.
authors.forename: Wendy Gwirtzman
authors.initials: WG
authors.lastname: Lane
authors.forename: Howard
authors.initials: H
authors.lastname: Dubowitz
authors.forename: Patricia
authors.initials: P
authors.lastname: Langenberg
authors.forename: Patricia
authors.initials: P
authors.lastname: Dischinger
mesh_terms: D000007:Abdominal Injuries / Q000453:epidemiology*; D002648:Child; D002649:Child Abuse / Q000639:trends*; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D016208:Databases, Factual; D005260:Female; D006760:Hospitalization / Q000639:trends*; D006801:Humans; D007223:Infant; D008297:Male; D018570:Risk Assessment; D014481:United States / Q000453:epidemiology