Allison E Curry1, Kristy B Arbogast2, Kristina B Metzger3, Ronni S Kessler3, Matthew J Breiding4, Juliet Haarbauer-Krupa4, Lara DePadilla4, Arlene Greenspan4, Christina L Master5. 1. Center for Injury Research and Prevention, Children's Hospital of Philadelphia, Philadelphia, PA; Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA. Electronic address: currya@email.chop.edu. 2. Center for Injury Research and Prevention, Children's Hospital of Philadelphia, Philadelphia, PA; Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA. 3. Center for Injury Research and Prevention, Children's Hospital of Philadelphia, Philadelphia, PA. 4. National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA. 5. Center for Injury Research and Prevention, Children's Hospital of Philadelphia, Philadelphia, PA; Sports Medicine and Performance Center, Children's Hospital of Philadelphia, Philadelphia, PA.
Abstract
OBJECTIVE: To quantify the risk of repeat concussions for children and identify demographic and clinical aspects of the index concussion associated with repeat injury. STUDY DESIGN: For this retrospective cohort study, we queried the Children's Hospital of Philadelphia healthcare network's unified electronic health record to identify all 5- to 15-year-old patients who had their first clinical visit for an index concussion at a Children's Hospital of Philadelphia location from July 2012 through June 2013. A 25% random sample (n = 536) were selected. Clinical data were abstracted for their index concussion and all concussion-related visits for 2 years following the index concussion. RESULTS: Overall, 16.2% (n = 87) of patients experienced at least 1 repeat concussion within 2 years of their index concussion. The risk of repeat concussion increased with patient age (9.5% for ages 5-8 years; 10.7% for ages 9-11 years; and 19.8% for ages 12-15 years). After we adjusted for other factors, risk was particularly heightened among patients whose index concussion had a longer clinical course (>30 vs 0-7 days, adjusted risk ratio 1.65 [1.01-2.69]) and greater symptom burden (>11 vs 0-2 symptoms, adjusted risk ratio 2.12 [1.12-3.72]). CONCLUSIONS: We estimate that 1 in 6 youth diagnosed with a concussion are diagnosed with a subsequent concussion within 2 years and that several clinical characteristics of the index concussion increase this risk. Identifying factors associated with a repeat injury is essential to inform the clinical management of concussion and direct injury prevention efforts.
OBJECTIVE: To quantify the risk of repeat concussions for children and identify demographic and clinical aspects of the index concussion associated with repeat injury. STUDY DESIGN: For this retrospective cohort study, we queried the Children's Hospital of Philadelphia healthcare network's unified electronic health record to identify all 5- to 15-year-old patients who had their first clinical visit for an index concussion at a Children's Hospital of Philadelphia location from July 2012 through June 2013. A 25% random sample (n = 536) were selected. Clinical data were abstracted for their index concussion and all concussion-related visits for 2 years following the index concussion. RESULTS: Overall, 16.2% (n = 87) of patients experienced at least 1 repeat concussion within 2 years of their index concussion. The risk of repeat concussion increased with patient age (9.5% for ages 5-8 years; 10.7% for ages 9-11 years; and 19.8% for ages 12-15 years). After we adjusted for other factors, risk was particularly heightened among patients whose index concussion had a longer clinical course (>30 vs 0-7 days, adjusted risk ratio 1.65 [1.01-2.69]) and greater symptom burden (>11 vs 0-2 symptoms, adjusted risk ratio 2.12 [1.12-3.72]). CONCLUSIONS: We estimate that 1 in 6 youth diagnosed with a concussion are diagnosed with a subsequent concussion within 2 years and that several clinical characteristics of the index concussion increase this risk. Identifying factors associated with a repeat injury is essential to inform the clinical management of concussion and direct injury prevention efforts.
Authors: Alexis Chiang Colvin; Jimmy Mullen; Mark R Lovell; Robin Vereeke West; Micky W Collins; Megan Groh Journal: Am J Sports Med Date: 2009-05-21 Impact factor: 6.202
Authors: Robert A Stern; David O Riley; Daniel H Daneshvar; Christopher J Nowinski; Robert C Cantu; Ann C McKee Journal: PM R Date: 2011-10 Impact factor: 2.298
Authors: William P Meehan; Rebekah C Mannix; Andrea Stracciolini; R J Elbin; Michael W Collins Journal: J Pediatr Date: 2013-04-26 Impact factor: 4.406
Authors: Bonnie R Swaine; Camille Tremblay; Robert W Platt; Guy Grimard; Xun Zhang; I Barry Pless Journal: Pediatrics Date: 2007-04 Impact factor: 7.124
Authors: Mark R Lovell; Grant L Iverson; Michael W Collins; Kenneth Podell; Karen M Johnston; Dustin Pardini; Jamie Pardini; John Norwig; Joseph C Maroon Journal: Appl Neuropsychol Date: 2006
Authors: Lindsay Ferguson; Christopher C Giza; Rebecka O Serpa; Tiffany Greco; Michael Folkerts; Mayumi L Prins Journal: Front Neurol Date: 2021-01-08 Impact factor: 4.003
Authors: José Tamez-Peña; Peter Rosella; Saara Totterman; Edward Schreyer; Patricia Gonzalez; Arun Venkataraman; Steven P Meyers Journal: Front Neurol Date: 2022-01-10 Impact factor: 4.003