Association of cumulative loneliness with all-cause mortality among middle-aged and older adults in the United States, 1996 to 2019.

Loneliness is a growing public health concern worldwide. We characterized the association between cumulative loneliness and subsequent all-cause mortality, using data from 9,032 participants aged 50+ in the population-based US Health and Retirement Study (HRS) from 1996 to 2019. Loneliness status (yes; no) was measured biennially from 1996 to 2004, and we categorized the experience of cumulative loneliness over the 8-y period as never, one time point, two time points, and ≥three time points. A multivariable-adjusted age-stratified Cox proportional hazards regression model was fitted to examine the association between cumulative loneliness from 1996 to 2004 and all-cause mortality from 2004 to 2019. Excess deaths due to each category of cumulative loneliness were calculated. Compared to those who never reported loneliness from 1996 to 2004, participants experiencing loneliness at one time point, two time points, and ≥three time points respectively had 1.05 (95% CI: 0.96 to 1.15), 1.06 (95% CI: 0.95 to 1.19), and 1.16 (95% CI: 1.02 to 1.33) times higher hazards of mortality from 2004 to 2019 (P trend = 0.01). These results correspond to 106 (95% CI: 68 to 144), 202 (95% CI: 146 to 259), and 288 (95% CI: 233 to 343) excess deaths per 10,000 person-years, for those experiencing loneliness at each of one, two, or ≥three time points from 1996 to 2004. Cumulative loneliness in mid-to-later life may thus be a mortality risk factor with a notable impact on excess mortality. Loneliness may be an important target for interventions to improve life expectancy in the United States.

Does structural racism impact receipt of NCCN guideline-concordant breast cancer treatment?

PURPOSE: Disparities in breast cancer survival remain a challenge. We aimed to analyze the effect of structural racism, as measured by the Index of Concentration at the Extremes (ICE), on receipt of National Cancer Center Network (NCCN) guideline-concordant breast cancer treatment. METHODS: We identified patients treated at two institutions from 2005 to 2017 with stage I-IV breast cancer. Census tracts served as neighborhood proxies. Using 5-year estimates from the American Community Survey, 5 ICE variables were computed to create 5 models, controlling for economic segregation, non-Hispanic Black (NHB) segregation, NHB/economic segregation, Hispanic segregation, and Hispanic/economic segregation. Multi-level logistic regression models were used to determine the association between individual and neighborhood-level characteristics on receipt of NCCN guideline-concordant breast cancer treatment. RESULTS: 5173 patients were included: 55.2% were Hispanic, 27.5% were NHW, and 17.3% were NHB. Regardless of economic or residential segregation, a NHB patient was less likely to receive appropriate treatment [(OR)Model1 0.58 (0.45-0.74); ORModel2 0.59 (0.46-0.78); ORModel3 0.62 (0.47-0.81); ORModel4 0.53 (0.40-0.69); ORModel5 0.59(0.46-0.76); p < 0.05]. CONCLUSION: To our knowledge, this is the first analysis assessing receipt of NCCN guideline-concordant treatment by ICE, a validated measure for structural racism. While much literature emphasizes neighborhood-level barriers to treatment, our results demonstrate that compared to NHW patients, NHB patients are less likely to receive NCCN guideline-concordant breast cancer treatment, independent of economic or residential segregation. Our study suggests that there are potential unaccounted individual or neighborhood barriers to receipt of appropriate care that go beyond economic or residential segregation.

Associations Between Neighborhood-Level Income and Triple-Negative Breast Cancer in a Majority-Minority Population.

BACKGROUND: Previous studies on disparities in triple-negative breast cancer (TNBC) focus on race/ethnicity, with few exploring the impact of contextual factors such as neighborhood-level income. This study evaluates the effect of neighborhood-level income on disparities in TNBC among a racially and ethnically diverse cohort, after accounting for granular individual-level risk factors of TNBC. PATIENTS AND METHODS: Patients with stage I-IV breast cancer from 2005 to 2017 were identified from our local tumor registry. The primary outcome was diagnosis of TNBC. Using 5-years estimates from the American Community Survey, we obtained median household income for each census tract which was categorized into quartiles. Mixed effects logistic regression was conducted and stratified by race and ethnicity, controlling for individual-level sociodemographic, comorbidities, and tumor characteristics. RESULTS: Among 5377 breast cancer registry patients, 16.5% were diagnosed with TNBC. The majority were Hispanic (50.1%) followed by non-Hispanic Black (NHB) (28.0%). After controlling for individual-level covariables including race and ethnicity, comorbidities, and tumor characteristics, women from low-income neighborhoods had increased odds of TNBC compared with other breast cancer subtypes, compared with those in high-income neighborhoods [odds ratio (OR) 1.33; 95% confidence interval (CI) 1.04, 1.70, p < 0.001]. In stratified analyses, NHB patients from low-income neighborhoods had two times the odds of TNBC diagnosis compared with those from high-income neighborhoods (OR 2.11; 95% CI 1.02, 4.37). CONCLUSION: We found that living in a low-income neighborhood is associated with an increased odds of TNBC independent of granular individual-level TNBC risk factors, particularly NHB race. More striking, NHB living in low-income neighborhoods had increased odds of TNBC compared with NHB living in high-income neighborhoods. Our results suggest potential unaccounted gene-environment and/or social (api)genomic interactions between neighborhood-level income and TNBC subtype development.

Does education moderate gender disparities in later-life memory function? A cross-national comparison of harmonized cognitive assessment protocols in the United States and India.

INTRODUCTION: We compared gender disparities in later-life memory, overall and by education, in India and the United States (US). METHODS: Data (N = 7443) were from harmonized cognitive assessment protocols (HCAPs) in the Longitudinal Aging Study of India-Diagnostic Assessment of Dementia (LASI-DAD; N = 4096; 2017-19) and US Health and Retirement Study HCAP (HRS-HCAP; N = 3347; 2016-17). We derived harmonized memory factors from each study using confirmatory factor analysis. We used multivariable-adjusted linear regression to compare gender disparities in memory function between countries, overall and by education. RESULTS: In the United States, older women had better memory than older men (0.28 SD-unit difference; 95% CI: 0.22, 0.35). In India, older women had worse memory than older men (-0.15 SD-unit difference; 95% CI: -0.20, -0.10), which attenuated with increasing education and literacy. CONCLUSION: We observed gender disparities in memory in India that were not present in the United States, and which dissipated with education and literacy.

A qualitative community health assessment of HIV prevention awareness in a semi-rural Latinx seasonal farm working community in South Florida.

This article explores HIV awareness and prevention in a Latinx seasonal farmworker community of south Miami-Dade County in the USA. The study took place as part of a larger community assessment that aimed to determine community needs and resources related to substance abuse, violence and HIV in the Latinx seasonal farmworker communities of south Miami-Dade County, with a particular focus on fathers' and their male sons' relationships. The study collected data on HIV knowledge and prevention, healthcare-seeking behaviours, cultural norms, and communication barriers about HIV prevention between fathers and sons. Data were collected through in-depth interviews with community leaders, two focus groups with social and health services providers, and four focus groups involving fathers and their adolescent sons. A deductive approach to data analysis was undertaken. Five major themes were identified: (1) HIVrelated knowledge and perception; (2) HIV prevention strategies; (3) barriers and needs for tailored preventive health and care services in the community; (4) stress over sex-related communication; and (5) the dominance of traditional masculine gender norms in the household and the community.

Cumulative loneliness and subsequent memory function and rate of decline among adults aged ≥50 in the United States, 1996 to 2016

INTRODUCTION: The study objective was to investigate the association between loneliness duration and memory function over a 20-year period. METHODS: Data were from 9032 adults aged ≥50 in the Health and Retirement Study. Loneliness status (yes vs. no) was assessed biennially from 1996 to 2004 and its duration was categorized as never, 1 time point, 2 time points, and ≥3 time points. Episodic memory was assessed from 2004 to 2016 as a composite of immediate and delayed recall trials combined with proxy-reported memory. Mixed-effects linear regression models were fitted. RESULTS: A longer duration of loneliness was associated with lower memory scores (P < 0.001) and a faster rate of decline (P < 0.001). The association was stronger among adults aged ≥65 than those aged <65 (three-way interaction P = 0.013) and was stronger among women than men (three-way interaction P = 0.002). DISCUSSION: Cumulative loneliness may be a salient risk factor for accelerated memory aging, especially among women aged ≥65. HIGHLIGHT: A longer duration of loneliness was associated with accelerated memory aging. The association was stronger among women than men and among older adults than the younger. Reducing loneliness in mid- to late life may help maintain memory function.

Alcohol use severity among recent Latino immigrants: Associations of acculturation, family history of alcohol use and alcohol outcome expectancies.

Having a family history of alcohol (FH+) use is a well-documented risk factor for alcohol use and alcohol related problems. However, there are limited studies examining the impact of FH + on current alcohol use among Latino immigrants. This study aimed to determine the influence of having a FH + on current alcohol use among Latino immigrants and the influence of alcohol outcome expectancies (AOEs) and acculturation on this relationship. This is a longitudinal secondary data analysis of data from the Recent Latino Immigrant Study (RLIS), the first community-based cohort study to examine pre- to post-immigration alcohol use trajectories of young adult Latino immigrants. Linear mixed models were performed to assess the association between various pre- and post-immigration factors and alcohol use among Latino immigrants. There were 518 young adult Latino immigrants with 18.7% reporting a FH + with those with a FH + having higher mean AUDIT score compared to those without (4.74 vs. 3.81; p = 0.028). Positive AOEs were associated with increase AUDIT scores. FH + individuals with greater positive AOEs experienced higher AUDIT scores compared to FH- individuals. Family cohesion was protective against alcohol use while endorsement of Americansism was associated with increased alcohol use. Theses results provide the framework for more in-depth exploration regarding the influences of FH+, AOEs, and acculturation have on the alcohol use among Latino immigrants. Future longitudinal research studies should account for whether traditional cultural values mediate or moderate the relationship between a FH+, AOE, and alcohol use of Latino immigrants.

New directions in cancer and aging: State of the science and recommendations to improve the quality of evidence on the intersection of aging with cancer control.

BACKGROUND: The global population of older cancer survivors is growing. However, the intersections of aging-related health risks across the cancer control continuum are poorly understood, limiting the integration of aging into cancer control research and practice. The objective of this study was to review the state of science and provide future directions to improve the quality of evidence in 6 priority research areas in cancer and aging. METHODS: The authors identified priority research areas in cancer and aging through an evidence-based Research Jam process involving 32 investigators and trainees from multiple disciplines and research centers in aging and cancer; then, they conducted a narrative review of the state of the science and future directions to improve the quality of evidence in these research areas. Priority research areas were defined as those in which gaps in scientific evidence or clinical practice limit the health and well-being of older adults with cancer. RESULTS: Six priority research areas were identified: cognitive and physical functional outcomes of older cancer survivors, sampling issues in studies of older cancer survivors, risk and resilience across the lifespan, caregiver support and well-being, quality of care for older patients with cancer, and health disparities. Evidence in these areas could be improved through the incorporation of bias reduction techniques into longitudinal studies of older cancer survivors, novel data linkage, and improved representation of older adults in cancer research. CONCLUSIONS: The priority research areas and methodologies identified here may be used to guide interdisciplinary research and improve the quality of evidence on cancer and aging.

Structural Racism and Breast Cancer-specific Survival: Impact of Economic and Racial Residential Segregation.

OBJECTIVE: To analyze the effect of economic and racial/ethnic residential segregation on breast cancer-specific survival (BCSS) in South Florida, a diverse metropolitan area that mirrors the projected demographics of many United States regions. SUMMARY BACKGROUND DATA: Despite advances in diagnosis and treatment, racial and economic disparities in BCSS. This study evaluates these disparities through the lens of racial and economic residential segregation, which approximate the impact of structural racism. METHODS: Retrospective cohort study of stage I to IV breast cancer patients treated at our institution from 2005 to 2017. Our exposures include index of concentration at the extremes, a measurement of economic and racial neighborhood segregation, which was computed at the census-tract level using American Community Survey data. The primary outcome was BCSS. RESULTS: Random effects frailty models predicted that patients living in low-income neighborhoods had higher mortality compared to those living in high-income neighborhoods [hazard ratios (HR): 1.56, 95% confidence interval (CI): 1.23-2.00]. Patients living in low-income non-Hispanic Black and Hispanic neighborhoods had higher mortality compared to those living in high-income non-Hispanic White (NHW) neighborhoods (HR: 2.43, 95%CI: 1.72, 3.43) and (HR: 1.99, 95%CI: 1.39, 2.84), after controlling for patient characteristics, respectively. In adjusted race-stratified analysis, NHWs living in low-income non-Hispanic Black neighborhoods had higher mortality compared to NHWs living in high-income NHW neighborhoods (HR: 4.09, 95%CI: 2.34-7.06). CONCLUSIONS: Extreme racial/ethnic and economic segregation were associated with lower BCSS. We add novel insight regarding NHW and Hispanics to a growing body of literature that demonstrate how the ecological effects of structural racism-expressed through poverty and residential segregation-shape cancer survival.

Does a Cancer Diagnosis in Mid-to-Later Life Modify Racial Disparities in Memory Aging?

BACKGROUND: It is unknown whether an incident cancer diagnosis differentially impacts acute and long-term memory aging between older White and Black Americans. METHODS: Incident cancer diagnoses and memory (immediate and delayed recall, combined with proxy-reported memory) were assessed at biennial study interviews in the US Health and Retirement Study (N=14,235, 1998-2016). We used multivariable segmented linear mixed-effects models to evaluate the rate of change in standardized memory score (SD/decade) in the years before, acutely at the time of, and in the years following an incident cancer diagnosis, compared to cancer-free adults, by race. RESULTS: Black participants experienced faster memory decline than White participants (cancer-free group: -1.211 vs. -1.077; P<0.0001). An incident cancer diagnosis was associated with an acute memory drop in White, but not Black participants (-0.065 vs. 0.024; P<0.0001). However, White cancer survivors experienced slower memory decline than cancer-free White adults before and after diagnosis, but this memory advantage was not observed among Black cancer survivors. CONCLUSIONS: Racial disparities in memory aging are not modified by an incident cancer diagnosis. The acute cancer-related memory decline and long-term memory advantage experienced by White, but not Black, cancer survivors relative to cancer-free older adults, requires further investigation.

Prescription Drug and Cannabis Use among Recent Latinx Immigrants Pre- and Post-Immigration to the US.

Introduction: Shifts in the sociopolitical context of Latin America have led to steep increases in recent Latinx immigrants (RLI) arriving in the US within the context of forced migration. Yet, little is known about how adverse experiences of RLIs before and after immigration may impact their health including drug use. The purpose of this study was to examine prescription drug and cannabis use before and just after immigration among RLIs and how this drug use is influenced by pre-and post-immigration factors. Methods: This study utilized baseline data from a study examining pre- to post-immigration drinking and driving trajectories among RLI in the United States (US). Baseline criteria included: self-identifying as a Latinx immigrant, 18 - 34 years old, who recently immigrated from a Latin American country. Multivariate logistic regression was conducted to determine predictors of drug use both prior to and after immigrating. Results: There were 540 RLI, 50.2% male and 47.8% subjected to forced migration. Prescription and illicit drug use decreased post-immigration with sedatives being the most common. Higher levels of education was associated with increased odds of pre-immigration prescription drug use and cannabis use. Those experiencing forced migration were more likely to engage in prescription drug use before and after immigration, while no associations were found for cannabis use. Conclusion: Findings suggest a need for increased substance use and mental health services among RLIs arriving within the context of forced migration. More research is needed to understand the trajectories of drug use among RLI as their time in the US increases.

Racial/Ethnic Disparities in the Incidence of Epithelial Ovarian Cancer in Florida by Histology, 2001-2015: Analysis of Trends.

OBJECTIVES: Because the population in Florida is 25.6% Hispanic, it is possible to evaluate the influence of race and ethnicity within clinically relevant subgroups of women with epithelial ovarian cancer (EOC), including histology and tumor grade. This study explores racial/ethnic disparities in the incidence of EOC in Florida by histology and tumor grade. METHODS: This study is an analysis of the Florida Cancer Database System. All incidence EOC cases from 2001 through 2015 were identified. Age-adjusted incidences were calculated and trends modeled by race/ethnicity and histology using Joinpoint and Poisson regression. RESULTS: In total, 80% of the 21,731 women with EOC were White, followed by Hispanic (13.1%) and non-Hispanic Black (7.9%). All races/ethnicities had statistically significant declines in incidence, with non-Hispanic White and non-Hispanic Black women having the steepest declines (annual percentage change -2.5, 95% confidence interval [CI] -5.9 to -2.1 and annual percentage change -2.8, 95% CI -4.8 to -1.5, respectively). A decreased incidence trend across the time period was seen for all subgroups (relative risk 0.97 [95% CI 0.96-0.98], 0.96 [95% CI 0.96-0.99], and 0.98 [95% CI 0.96-0.99] for non-Hispanic White, non-Hispanic Black, and Hispanic). High-grade EOC incidence for all groups did not change with time. CONCLUSIONS: We found significant declines in the incidence of EOC for all races/ethnicities, but not for high-grade EOC. The observed incidence decline in Hispanic women differs from previous research. More research is needed to understand women the causes of overall racial/ethnic differences and the decline in EOC.

Associations of Objective and Perceived Neighborhood Ethnic Density on Hazardous Alcohol Use among Latinx Emerging Adults.

Background/Purpose: Emerging adulthood is an important time where substance use often peaks. Neighborhood Latinx ethnic density could be protective against negative health behaviors. Most studies on neighborhood ethnic density have focused on census-level aggregate measures, however perception of the neighborhood ethnic density could differ from objectively measured neighborhood density. This study investigated the effects of neighborhood ethnic density, both perceived ethnic and objectively measured ethnic density, on hazardous alcohol use among Latinx emerging adults in Maricopa County Arizona and Miami-Dade County Florida by gender. Methods: 200 Latinx emerging adults residing in Arizona and Florida completed a cross-sectional survey. Inclusion criteria were being age 18-25, self-identify as Latinx, and currently living in Maricopa County or Miami-Dade County. Data were analyzed using multivariate logistic regression and moderation analyses. Results: There was a statistically significant difference between perceived and objective ethnic density (Kappa = 0.353, p < 0.001). When ethnic density was measured objectively, alcohol use severity was statistically significantly lower for individuals living in highly ethnically dense neighborhoods (OR: 0.34, 95% CI: 0.12, 0.92). However, this association was only found for women in moderation analyses. There was no statistically significant association between perceived ethnic density and alcohol use severity. Conclusion: The present study found a statistically significant decrease in alcohol use severity among Latinx emerging adults who live in highly ethnically dense neighborhoods after adjusting for covariates. Future research should investigate the potential mechanisms in which these neighborhoods protect against alcohol use severity among Latinx emerging adults.

Socio-Cultural Subgroups of Latina/o Immigrants: A Latent Profile Analysis.

Socio-cultural factors, such as familismo, social support, machismo, and multigroup ethnic identity, are strongly associated with Latina/o immigrants' alcohol misuse and depressive symptoms. However, research has rarely explored whether unobserved groups of Latina/o immigrants with similar socio-cultural factors exist. Latent Profile analysis can illuminate which subgroups to target, or which socio-cultural factors need to be supported, to have an impact on the prevention and treatment of alcohol use and/or depression in the Latina/o immigrant population. Cross sectional data from on ongoing longitudinal investigation was utilized (N= 518 Latina/o adults living in Miami-Dade County, Florida and have immigrated to the US within one year prior to assessment). Latent Profile Analyses (LPA) were conducted utilizing validated measures of familismo, social support, neighborhood collective efficacy, ethnic identity, machismo, caballerismo, and marianismo. The LPA revealed three, significantly different profiles: (1) low socio-cultural protection (n=155, 29.98%), (2) high socio-cultural protection (n=21, 4.06%), and (3) high socio-, low-cultural protection (n=341, 65.96%). Profile membership was associated significantly with immigrant documentation status, education level, and past family history of substance use. Results indicate that Latina/o immigrants in the low socio-cultural protection group had significantly higher alcohol use compared to high socio-, low cultural protection group. No significant differences were found for depressive symptoms. We discuss implications of our findings and encourage researchers to continue to unpack the complexities associated with socio-cultural factors and Latina/o mental and behavioral health. Specifically, research should focus on socio-cultural factors can provide protection from negative health outcomes and increase resiliency among this population.

Residential segregation and overall survival of women with epithelial ovarian cancer.

BACKGROUND: To the authors' knowledge, the etiology of survival disparities in patients with epithelial ovarian cancer (EOC) is not fully understood. Residential segregation, both economic and racial, remains a problem within the United States. The objective of the current study was to analyze the effect of residential segregation as measured by the Index of Concentration at the Extremes (ICE) on EOC survival in Florida by race and/or ethnicity. METHODS: All malignant EOC cases were identified from 2001 through 2015 using the Florida Cancer Data System (FCDS). Census-defined places were used as proxies for neighborhoods. Using 5-year estimates from the American Community Survey, 5 ICE variables were computed: economic (high vs low), race and/or ethnicity (non-Hispanic white [NHW] vs non-Hispanic black [NHB] and NHW vs Hispanic), and racialized economic segregation (low-income NHB vs high-income NHW and low-income Hispanic vs high-income NHW). Random effects frailty models were conducted. RESULTS: A total of 16,431 malignant EOC cases were diagnosed in Florida among women living in an assigned census-defined place within the time period. The authors found that economic and racialized economic residential segregations influenced EOC survival more than race and/or ethnic segregation alone in both NHB and Hispanic women. NHB women continued to have an increased hazard of death compared with NHW women after controlling for multiple covariates, whereas Hispanic women were found to have either a similar or decreased hazard of death compared with NHW women in multivariable Cox models. CONCLUSIONS: The results of the current study indicated that racial and economic residential segregation influences survival among patients with EOC. Research is needed to develop more robust segregation measures that capture the complexities of neighborhoods to fully understand the survival disparities in EOC.

Racial and ethnic disparities in the overall survival of women with epithelial ovarian cancer in Florida, 2001-2015.

Many studies have focused on white and black disparities in epithelial ovarian cancer (EOC) but fewer include Hispanics. Florida presents a unique opportunity to study racial/ethnic disparities. This study examined racial/ethnic disparities in the overall survival of women with EOC in Florida by histology. All EOC cases from 2001 through 2015 were identified in the Florida Cancer Database System (FCDS). Survival curves by race/ethnicity and histology were generated by Kaplan-Meier methods. Cox regression evaluated the associations between race/ethnicity, histology, and survival. Eligible EOC cases (n = 21,721) identified in the 2001-2015 FCDS were included in the study. The median survival for non-Hispanic whites (NHWs), non-Hispanic blacks (NHBs), and Hispanics was 31, 21, and 35 months, respectively (p < 0.001). NHB had an increased [AHR 1.23 (95% CI 1.15, 1.30)] and Hispanics a nonsignificant decreased hazard [AHR 0.96 (95% CI 0.91, 1.02)] of death compared to NHW after controlling for other demographic, treatment, and tumor characteristics. Relative to NHWs, NBH had worse survival while Hispanics had equivalent survival. Future research should consider evaluating genetic and epigenetic modifications, and prevalence of cancer syndromes to further elucidate the etiologies of disease in these disparate populations.

Racial differences in adult-onset MRI-negative temporal lobe epilepsy.

OBJECTIVE: We recently detected a significant racial difference in our population with temporal lobe epilepsy (TLE) at the University of Alabama at Birmingham (UAB) seizure monitoring unit. We found that Black patients were more likely than their White counterparts to carry a TLE diagnosis. Using this same patient population, we focus on the patients with TLE to better describe the relationship between race and epidemiology in this population. METHODS: We analyzed the data from patients diagnosed with TLE admitted to the UAB seizure monitoring unit between January 2000 and December 2011. For patients with a video electroencephalography (EEG) confirmed diagnosis of TLE (n = 385), basic demographic information including race and magnetic resonance imaging (MRI) findings were collected. Descriptive statistics and multivariate logistic regression were used to explore the relationship between MRI findings, demographic data, and race. RESULTS: For Black patients with TLE, we found that they were more likely to be female (odds ratio [OR] = 1.91, 95% confidence interval [CI]: 1.14-3.19), have seizure onset in adulthood (OR = 2.39, 95% CI: 1.43-3.19), and have normal MRIs (OR = 1.69, 95% CI: 1.04-2.77) compared to White counterparts with TLE after adjusting for covariates. CONCLUSIONS: These data suggest that Black race (compared to White) is associated with higher expression of adult-onset MRI-negative TLE, an important subtype of epilepsy with unique implications for evaluation, treatment, and prognosis. If validated in other cohorts, the findings may explain the lower reported rates of epilepsy surgery utilization among Blacks. The racial differences in surgical utilization could be due to a greater prevalence of an epilepsy that is less amenable to surgical resection rather than to cultural differences or access to care.

Identifying Characteristics in Abusive Head Trauma: A Single-Institution Experience.

Abusive head trauma (AHT) is a significant cause of childhood morbidity and mortality. The purpose of this study was to better understand the trends centered on AHT patients treated at Vanderbilt Children's Hospital. A retrospective study of 139 children undergoing treatment and management for traumatic brain injury due to abuse between January 2006 and April 2013 at Vanderbilt Children's Hospital was conducted. Caucasian males made up 61% and the youngest sibling represented 86.3% of our cohort. The median age was 5 months with injuries occurring during summertime and on weekdays, 31 and 63%, respectively. Seventy-nine percent were diagnosed with subdural hematomas, and 42% had a Glasgow Coma Scale (GCS) of 8 or less. A total of 25 patients, median age 8.6 months, died during our study period. The results of this study describe the AHT population at Vanderbilt Children's Hospital. Future studies should prospectively assess this population to better understand social factors involved in AHT.