BACKGROUND: Although head trauma-related deaths, hospitalizations, and emergency department visits are well characterized, few studies describe pediatric patients presenting outside of emergency departments. We compared the epidemiology and extent of healthcare-seeking pediatric (0-17 years) patients presenting in outpatient settings with those of patients seeking nonhospitalized emergency department care. METHODS: We used MarketScan Medicaid and commercial claims, 2004-2013, to identify patients managed in two outpatient settings (physician's offices/clinics, urgent care) and the emergency department. We then examined differences in demographic and injury-specific factors, Centers for Disease Control and Prevention-defined head trauma diagnoses, the extent of and reasons for post-index visit ambulatory care use within 30/90/180 days, and annual and monthly variations in head trauma trends. Outpatient incidence rates in 2013 provided estimates of the nationwide US outpatient burden. RESULTS: A total of 1,683,097 index visits were included, representing a nationwide burden in 2013 of 844,660 outpatient cases, a number that encompassed 51% of healthcare-seeking head trauma that year and that substantially increased in magnitude from 2004 to 2013. Two-thirds (68%) were managed in outpatient settings. While demographic distributions varied with index-visit location, injury-specific factors were comparable. Seasonal spikes appeared to coincide with school sports. CONCLUSIONS: There is an urgent need to better understand the natural history of head trauma in the >800,000 pediatric patients presenting each year for outpatient care. These outpatient injuries, which are more than double the number of head trauma cases recorded in the hospital-affiliated settings, illustrate the potential importance of expanding inclusion criteria in surveillance and prevention efforts designed to address this critical issue.
BACKGROUND: Although head trauma-related deaths, hospitalizations, and emergency department visits are well characterized, few studies describe pediatric patients presenting outside of emergency departments. We compared the epidemiology and extent of healthcare-seeking pediatric (0-17 years) patients presenting in outpatient settings with those of patients seeking nonhospitalized emergency department care. METHODS: We used MarketScan Medicaid and commercial claims, 2004-2013, to identify patients managed in two outpatient settings (physician's offices/clinics, urgent care) and the emergency department. We then examined differences in demographic and injury-specific factors, Centers for Disease Control and Prevention-defined head trauma diagnoses, the extent of and reasons for post-index visit ambulatory care use within 30/90/180 days, and annual and monthly variations in head trauma trends. Outpatient incidence rates in 2013 provided estimates of the nationwide US outpatient burden. RESULTS: A total of 1,683,097 index visits were included, representing a nationwide burden in 2013 of 844,660 outpatient cases, a number that encompassed 51% of healthcare-seeking head trauma that year and that substantially increased in magnitude from 2004 to 2013. Two-thirds (68%) were managed in outpatient settings. While demographic distributions varied with index-visit location, injury-specific factors were comparable. Seasonal spikes appeared to coincide with school sports. CONCLUSIONS: There is an urgent need to better understand the natural history of head trauma in the >800,000 pediatric patients presenting each year for outpatient care. These outpatient injuries, which are more than double the number of head trauma cases recorded in the hospital-affiliated settings, illustrate the potential importance of expanding inclusion criteria in surveillance and prevention efforts designed to address this critical issue.
Authors: Won Hyung A Ryu; Anthony Feinstein; Angela Colantonio; David L Streiner; Deirdre R Dawson Journal: Can J Neurol Sci Date: 2009-07 Impact factor: 2.104
Authors: Kristy B Arbogast; Allison E Curry; Melissa R Pfeiffer; Mark R Zonfrillo; Juliet Haarbauer-Krupa; Matthew J Breiding; Victor G Coronado; Christina L Master Journal: JAMA Pediatr Date: 2016-07-05 Impact factor: 16.193
Authors: Victor G Coronado; Tadesse Haileyesus; Tabitha A Cheng; Jeneita M Bell; Juliet Haarbauer-Krupa; Michael R Lionbarger; Javier Flores-Herrera; Lisa C McGuire; Julie Gilchrist Journal: J Head Trauma Rehabil Date: 2015 May-Jun Impact factor: 2.710
Authors: Janet M Powell; Joseph V Ferraro; Sureyya S Dikmen; Nancy R Temkin; Kathleen R Bell Journal: Arch Phys Med Rehabil Date: 2008-07-02 Impact factor: 3.966
Authors: Victor G Coronado; Lisa C McGuire; Kelly Sarmiento; Jeneita Bell; Michael R Lionbarger; Christopher D Jones; Andrew I Geller; Nayla Khoury; Likang Xu Journal: J Safety Res Date: 2012-08-25
Authors: Christy L Collins; Keith Owen Yeates; Thomas L Pommering; Rebecca Andridge; Victor G Coronado; Julie Gilchrist; R Dawn Comstock Journal: Inj Epidemiol Date: 2014-05-06
Authors: Kimberly G Harmon; Jonathan A Drezner; Matthew Gammons; Kevin M Guskiewicz; Mark Halstead; Stanley A Herring; Jeffrey S Kutcher; Andrea Pana; Margot Putukian; William O Roberts Journal: Br J Sports Med Date: 2013-01 Impact factor: 13.800
Authors: Cheryl K Zogg; R Sterling Haring; Likang Xu; Joseph K Canner; Taylor D Ottesen; Ali Salim; Adil H Haider; Eric B Schneider Journal: Epidemiology Date: 2018-11 Impact factor: 4.822
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
Authors: Paula W Tucker; Rachel Bull; Alex Hall; Tim P Moran; Shabnam Jain; Usha Sathian; Harold K Simon; Gerard A Gioia; Jonathan J Ratcliff; David W Wright Journal: Front Public Health Date: 2022-02-17
Authors: Paul G Harch; Susan R Andrews; Cara J Rowe; Johannes R Lischka; Mark H Townsend; Qingzhao Yu; Donald E Mercante Journal: Med Gas Res Date: 2020 Jan-Mar