Predicting Time to Evaluation After Pediatric Concussion: Factors Affecting Specialty Concussion Care

Area of Science:

• Pediatric neurology
• Sports medicine
• Clinical outcomes research

Background:

• Timely clinical evaluation post-pediatric concussion is crucial for diagnosis, treatment, and prognosis.
• Patient factors like demographics, socioeconomic status, and medical history can influence evaluation timing and recovery.
• Understanding these factors can help optimize care pathways for pediatric concussion.

Purpose of the Study:

• To investigate the association between patient characteristics and the time to specialty concussion evaluation.
• To test the hypothesis that a history of concussion, prior relationship with a concussion program, or higher income would correlate with quicker evaluation.
• To identify factors influencing the delay or promptness of seeking specialized care after a pediatric concussion.

Main Methods:

• Cross-sectional study with Level 3 evidence.
• Retrospective review of medical records for 220 pediatric patients (ages 6-18) diagnosed with concussion in 2019.
• Primary outcome measured was the number of days between concussion date and initial specialty evaluation.

Main Results:

• Patients with a prior concussion history or existing relationship with the specialty clinic were evaluated significantly faster.
• A history of concussion was associated with a -1.72 day difference in evaluation time (P=.03).
• Referral by a primary care provider was linked to a significantly longer evaluation time (3.86 days, P<.0001).

Conclusions:

• A prior concussion diagnosis and established relationship with a concussion clinic facilitate earlier specialty evaluation.
• Referrals from primary care physicians may contribute to delays in accessing specialized concussion care.
• Potential barriers to accessing timely care after pediatric concussion warrant further investigation to improve early treatment initiation.