Liraz Fridman1, Michal Scolnik2, Alison Macpherson3, Linda Rothman4, Astrid Guttmann5, Anne M Grool6, Daniel Rodriguez Duque7, Roger L Zemek8. 1. York University, Toronto, Ontario, Canada. Electronic address: liraz@yorku.ca. 2. Technion American Medical School, Haifa, Israel. 3. York University, Toronto, Ontario, Canada; Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada. 4. York University, Toronto, Ontario, Canada. 5. Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada; Hospital for Sick Children, Department of Pediatrics, University of Toronto, Toronto, Ontario, Canada. 6. Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada. 7. Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada. 8. Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada; Department of Pediatrics and Emergency Medicine, University of Ottawa, Ottawa, Ontario, Canada.
Abstract
OBJECTIVE: To assess whether children and youth with concussion receive follow-up visits in accordance with the recommended guidelines. STUDY DESIGN: We conducted a retrospective, population-based study using linked health administrative data from all concussion-related visits to emergency department and physician offices by children aged 5 through 18 years (range, 5.00-18.99) in Ontario between 2003 and 2013. We analyzed the percentage of children and youth seen for follow-up. The Mann-Kendall test for trends was used to assess a monotonic increasing trend over time in concussion follow-up visits. RESULTS: A total of 126 654 children and youth were evaluated for an index concussion visit. The number of children and youth assessed for concussion follow-up (N = 45 155) has increased significantly over time (P < .001). In 2003, 781 of 7126 patients (11.0%; 95% CI, 10.3-11.7) with an index visit for concussion had a follow-up assessment. By 2013, 6526 of 21 681 (30.1%; 95% CI, 29.5-30.7) patients received follow-up care. CONCLUSIONS: The proportion of children and youth receiving follow-up after an acute concussion has significantly increased between 2003 and 2013. Nevertheless, more than two-thirds of all patients do not seek medical follow-up or clearance as recommended by current concussion guidelines, suggesting that ongoing efforts to improve and monitor compliance with recommended guidelines by patients and physicians are important.
OBJECTIVE: To assess whether children and youth with concussion receive follow-up visits in accordance with the recommended guidelines. STUDY DESIGN: We conducted a retrospective, population-based study using linked health administrative data from all concussion-related visits to emergency department and physician offices by children aged 5 through 18 years (range, 5.00-18.99) in Ontario between 2003 and 2013. We analyzed the percentage of children and youth seen for follow-up. The Mann-Kendall test for trends was used to assess a monotonic increasing trend over time in concussion follow-up visits. RESULTS: A total of 126 654 children and youth were evaluated for an index concussion visit. The number of children and youth assessed for concussion follow-up (N = 45 155) has increased significantly over time (P < .001). In 2003, 781 of 7126 patients (11.0%; 95% CI, 10.3-11.7) with an index visit for concussion had a follow-up assessment. By 2013, 6526 of 21 681 (30.1%; 95% CI, 29.5-30.7) patients received follow-up care. CONCLUSIONS: The proportion of children and youth receiving follow-up after an acute concussion has significantly increased between 2003 and 2013. Nevertheless, more than two-thirds of all patients do not seek medical follow-up or clearance as recommended by current concussion guidelines, suggesting that ongoing efforts to improve and monitor compliance with recommended guidelines by patients and physicians are important.
Authors: Keith O Yeates; Jennifer D Zwicker; Krystle Wittevrongel; Olesya Barrett; Isabelle Couloigner; Stefania Bertazzon; Brent Hagel; Kathryn J Schneider; David Johnson Journal: Pediatr Res Date: 2022-09-09 Impact factor: 3.953
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