Children’s Concussion Rates May Be Higher Than Thought

A significant gap has been discovered in U.S. tracking methods for childhood concussions, and researchers say current estimates of the nation’s pediatric concussions could be greatly lower than they should be.

The research, from The Children’s Hospital of Philadelphia (CHOP) and the Centers for Disease Control and Prevention (CDC), found that many current counts of children’s concussions are based only on emergency department visits or on organized high school and college athletics data.

But among 0- to 17-year-olds in the study who were diagnosed with a concussion, only 12 percent had their first visit at the emergency department (ED), with the rest having their first concussion visit at a primary care site, or specialty care (sports medicine, neurology, trauma).

Additionally, about one-third of the children were under 12, and therefore would not be included in any high school sports data.

Lead author Kristy Arbogast, PhD, co-scientific director of CHOP’s Center for Injury Research and Prevention, commented:

“We learned two really important things about pediatric concussion healthcare practices. First, 4 in 5 of this diverse group of children were diagnosed at a primary care practice — not the emergency department.

Second, one-third were under age 12, and therefore represent an important part of the concussion population that is missed by existing surveillance systems that focus on high school athletes.”

The study highlights the need to develop more accurate methods for tracking concussions among children in the United States. Ensuring that primary care doctors are properly trained and have the right clinical tools to diagnose and treat a concussion is also important.

Compared to more specialized settings, a primary care practice can usually see injured patients sooner, getting them on the right path for treatment earlier. Early diagnosis and treatment is key to recovery from a concussion. This includes early cognitive and physical rest, followed by a supervised return to learning and activity.

The majority of concussions will resolve with this approach in two to three weeks. Patients with lingering symptoms or conditions can be referred for specialist care.

Debra Houry, MD, MPH, director of CDC’s National Center for Injury Prevention and Control, says:

“We need surveillance that better captures concussions that occur in children and adolescents. Better estimates of the number, causes and outcomes of concussion will allow us to more effectively prevent and treat them, which is a priority area for CDC’s Injury Center.”

Kristy B. Arbogast et al.
Point of Health Care Entry for Youth With Concussion Within a Large Pediatric Care Network
JAMA Pediatrics, 2016 DOI: 10.1001/jamapediatrics.2016.0294

Image: Damian Gadal