Return to the Emergency Department Within 3 Months Following Pediatric Acute Concussion

Area of Science:

• Pediatric emergency medicine
• Neurology
• Public health

Background:

• Concussion is a common traumatic brain injury in children and adolescents.
• Understanding return visit patterns is crucial for optimizing healthcare resource allocation and patient management.
• Predictive clinical scores can aid in identifying at-risk individuals.

Purpose of the Study:

• To determine the proportion of pediatric concussion patients returning to the emergency department (ED) within three months.
• To identify clinical composite scores that best predict these return visits.
• To analyze risk factors associated with concussion-related ED revisits.

Main Methods:

• Combined secondary analysis of the 5P study data with retrospective medical record review.
• Included children aged 5-18 years diagnosed with concussion at the Children's Hospital of Eastern Ontario (CHEO) ED.
• Analyzed return visits within 3 months and 14 days, comparing 5P and Post-Concussion Symptom Inventory scores.

Main Results:

• 7.4% of children returned to the ED for concussion-related reasons within 3 months, primarily within the first 14 days.
• History of migraines and being female aged 13-18 years were associated with higher return rates.
• Headache was the most common symptom upon revisit; risk scores showed modest predictive improvement.

Conclusions:

• The majority of pediatric concussion patients do not require ED re-evaluation within three months.
• Female adolescents with elevated 5P scores may benefit from early, specialized concussion care.
• Identifying risk factors at the initial visit can potentially reduce healthcare burden and improve patient outcomes.