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A population-based study of paediatric emergency department and office visits for concussions from 2003 to 2010
Alison Macpherson1, Liraz Fridman2, Michal Scolnik2
1York University; ; Institute for Clinical Evaluative Sciences, The Hospital for Sick Children and Department of Paediatrics, University of Toronto, Toronto, Ontario.
Insights
Paediatric concussion visits to emergency departments and doctor
Area of Science:
- Pediatric Health
- Epidemiology
- Traumatic Brain Injury
Background:
- Limited data exists on the long-term epidemiological trends of pediatric concussions.
- Few studies have analyzed both emergency department (ED) and physician office visits for pediatric concussions.
Purpose of the Study:
- To analyze temporal trends in pediatric concussion visits to EDs and physician offices by age and sex.
- To identify the causes of concussions in children treated in EDs.
Main Methods:
- Retrospective, population-based study utilizing linked health administrative data.
- Analysis of concussion-related visits for children aged 3-18 in Ontario from 2003-2011.
- Inclusion of both emergency department and physician office visits.
Main Results:
- A statistically significant increase in pediatric concussion visits was observed in both EDs and physician offices between 2003 and 2010.
- Concussion rates per 100,000 children increased significantly for both boys and girls.
- Falls represented approximately one-third of pediatric concussions, with hockey/skating being the most frequent sports-related cause.
Conclusions:
- Rising healthcare utilization for pediatric concussions may reflect increased incidence and awareness.
- Evidence-based prevention strategies are crucial, particularly for sports and recreational activities.
- Further research into concussion etiology and prevention in pediatric populations is warranted.
Background:
There is a paucity of information regarding descriptive epidemiology of paediatric concussions over time, and few studies include both emergency department (ED) and physician office visits.
Objective:
To describe trends in visits for paediatric concussions in both EDs and physician offices according to age and sex. A secondary objective was to describe the cause of concussion for children treated in EDs.
Methods:
A retrospective, population-based study using linked health administrative data from all concussion-related visits to the ED or a physician office by school-age children and youth (three to 18 years of age) in Ontario between April 1, 2003 and March 3, 2011 was conducted.
Results:
The number of children evaluated in both EDs and a physician offices increased between 2003 and 2010, and this linear trend was statistically significant (P=0.002 for ED visits and P=0.001 for office visits). The rate per 100,000 increased from 466.7 to 754.3 for boys and from 208.6 to 440.7 for girls during the study period. Falls accounted for approximately one-third of the paediatric concussions. Hockey/skating was the most common specific cause of paediatric sports-related concussions.
Conclusions:
The increasing use of health care services for concussions is likely related to changes in incidence over time and increased awareness of concussion as a health issue. Evidence-based prevention initiatives to help reduce the incidence of concussion are warranted, particularly in sports and recreation programs.
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