Racial and Ethnic Differences in Emergency Department Utilization and Diagnosis for Sports-Related Head Injuries

Abstract

Background: Prior studies have shown racial differences in concussion awareness and outcome. Objective: To assess if racial or ethnic differences exist in Emergency Department (ED) utilization and diagnosis for children with sports-related head injuries. Methods: We performed a retrospective, cross-sectional analysis of ED visits from 2008 to 2017 using National Electronic Injury Surveillance System (NEISS) data. Population-weighted ED visits for children age 7–18 years with a sport-related injury were included. We compared the probability of an ED visit being for an injury to the head or diagnosed as a concussion between children of different races/ethnicities. Analyses were adjusted for age, gender, sport, year, and location where the injury occurred. Results: We identified 11,529,994 population-weighted ED visits for pediatric sports-related injuries, of which 1,497,717 (13.0%) were injuries to the head and 619,714 (5.4%) received a diagnosis of concussion. Black children were significantly less likely than non-Hispanic white children to have their ED visit be for an injury to the head [Odds Ratio (OR) 0.72, 95%CI 0.65–0.79] or concussion (OR 0.58, 95%CI 0.50–0.68). Black children presenting to the ED with an injury to their head were less likely than non-Hispanic white children to be diagnosed with a concussion (OR = 0.71, 95%CI 0.59–0.85). Conclusions: Racial differences exist in both ED utilization for pediatric sports-related head injuries and in the diagnosis of concussion. Further work is needed to understand these differences to ensure all brain injured athletes receive optimal care, regardless of race.

Disparities on Baseline Performance Using Neurocognitive and Oculomotor Clinical Measures of Concussion

“…Among youth and adolescent sports participants, Black/ African Americans are less likely to be diagnosed with a concussion compared with White/non-Hispanics. 23 However, Black/African American high school athletes in this study reported having higher symptom severity scores at baseline compared with White/non-Hispanics. There was an approximate difference of 2.5 between race at baseline.…”

Alcohol Use Disorder Increases Risk of Traumatic Brain Injury-Related Hospitalization: Insights From 3.8 Million Children and Adolescent Inpatients

“…TBI is more common in blacks compared to other races due to the fact that high violence rates are seen in black teens [16]. Black children are significantly less likely to have ED visits after a head injury, and less likely to be diagnosed with brain concussion compared to whites [17]. According to a study on children and adolescent hospitalizations, most children with TBI are male and white [18].…”

Race and Concussion: An Emerging Relationship

“…Of the 11,529,994 injuries for pediatric sport-related injuries, 13% were injuries to the head, and 5.4% of those patients were diagnosed with SRC. 9 African American patients were less likely than Caucasian patients to have ED visits for head injuries or concussions and were less likely to be diagnosed with a concussion during an ED visit. 9 …”

“… 9 African American patients were less likely than Caucasian patients to have ED visits for head injuries or concussions and were less likely to be diagnosed with a concussion during an ED visit. 9 …”