HealthDay News — Half of children, aged four years or under, who experience an abusive head trauma will die before 21 years of age. Among those children who survive severe injuries, their quality of life is expected to be cut in half, according to research published in Pediatrics.

To estimate the disability-adjusted life-year (DALY) burden of abusive head trauma in patients aged zero to four years in the United States, Ted Miller, PhD, of the Pacific Institute for Research and Evaluation in Calverton, Md., and colleagues examined vital statistics data from a national inpatient database.

To determine quality of life in children who survived an abusive head trauma, the investigators surveyed parents, caregivers, or pediatricians of 170 children.

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Of the 4824 patients who experienced abusive head trauma in 2009, 334 died within 30 days of the trauma, noted the researchers. All patients were aged less than five years, but nearly 80% of the patients were aged less than one year at the time of injury.

Only 16% of patients experienced minor abusive head trauma; another 13.5% experienced moderate injuries. The majority of patients (71%) experienced severe abusive head trauma. Almost one-quarter of the children required a feeding tube, and 57% were blind or legally blind. Among the patients with severe trauma, 86% lost their sight or needed corrective eye surgery, indicated the report authors.

Nearly 70,000 years of combined life and disability-free life were lost due to abusive head trauma in children in 2009. Children who had a mild or moderate injury lost about five years of disability-free life. Those with severe injuries lost 24 years of disability-free life.

“Abusive head trauma is extremely serious, often resulting in severe physical damage or death,” concluded the scientists.

“The annual DALY burden several years after mild AHT exceeds the DALY burden of a severe burn.”


  1. Miller TR et al. Pediatrics. 2014; doi: 10.1542/peds.2014-1385