Healthcare needs of survivors of abusive head trauma after hospitalization

Abusive head trauma (AHT) survivors suffer long-term impairments in physical, cognitive, and social abilities. While studies have demonstrated the long-term functional outcomes, the burden of healthcare needs upon discharge has not been evaluated. We aimed to describe the discharge needs and re-admission rates of survivors of abusive head trauma, exploring age impact. A retrospective chart review identified patients admitted to a single urban Level 1 Trauma Center in Michigan from 2010 to 2021, with suspected or confirmed abusive head trauma. Data collected from chart review included demographics, hospitalization characteristics, diagnostic evaluation, neurosurgical interventions, new discharge diagnoses, new equipment and medications, and post-admission care including therapies and medical support. Analysis involved comparing these characteristics between infants younger than 12 months and children older than 12 months. Of 124 subjects with suspected AHT during the study time frame, new medical needs upon discharge were common: 71 (57.3 %) received anti-epileptics, 19 (15.3 %) received feeding tubes, and 118 (95.2 %) required subspecialty follow-up. Subjects <12 months were less likely to receive physical (26/99, 26.3 % vs 13/25, 52 %; p = 0.013), occupational (25/99, 25.3 % vs 13/25, 52 %; p = 0.01), and speech therapy (9/99, 9.1 % vs 11/25, 44 %; p ≤0.0001), and less likely to be admitted to an inpatient rehabilitation program (6/99, 6.1 % vs 10/25, 40 %; p ≤0.0001). After abusive head trauma, medical needs including subspecialty follow-up, rehab services, and medications were common. Findings inform expectations for healthcare teams and families of AHT survivors at discharge.