Sports-Related Concussions in Children

O'Keefe, Kraigher; Beamon, Bradley; Brewer, Kori L.; Niceler, Brock

doi:10.1097/pec.0000000000001476

Pediatr Emer Care

2018

DOI: 10.1097/pec.0000000000001476

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Sports-Related Concussions in Children

Kraigher O'Keefe¹,

Bradley Beamon²,

Kori L. Brewer³

et al.

Abstract: Patients and parents who presented to a pediatric ED for sports-related head injury had a trend toward higher expectations of a CT scan being necessary to diagnose concussion and did have a higher rate of CT scans performed. Education of athletes and parents engaging in organized sports may be worthwhile to assist in setting expectations in diagnosis of concussion.

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Cited by 4 publications

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“…Early access to appropriate medical care influences recovery times by directing further and often specialized medical attention. 15,29,37 An athletic trainer (AT), a team physician, other health care providers, a coach, or any combination of these individuals may be involved in early SRC evaluations, 8 and additional stakeholders-including parents and athletes-may be involved in return to sport (RTS) decisions. 33 Despite additional health care provider involvement, ATs may be the first point of contact and vital to establishing an acute management plan.…”

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confidence: 99%

Acute Sport-Related Concussion Management and Return to Sport Time in High School Athletes

Bretzin,

Zynda,

Pollard-McGrandy

et al. 2024

Am J Sports Med

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Background: The current evidence for acute management practices of sport-related concussion (SRC) is often limited to in-clinic visits, with limited studies identifying professionals in early SRC care and the association with prolonged recovery outcomes. Purpose: To describe acute SRC management practices (ie, the personnel in the initial evaluations, removal from activity) and test the association with prolonged return to sport (RTS) time. Study Design: Descriptive epidemiology study. Methods: We conducted a retrospective cohort study of 17,081 high school SRCs accrued between the 2015-2016 and 2020-2021 academic years. We reported acute management practices and RTS time as frequencies stratified by sex, sport, and event type and compared athletic trainer (AT) access in initial evaluation with chi-square tests ( P < .05). Separate logistic regressions estimated odds ratios (ORs) and 95% CIs for removal from activity and prolonged RTS >21 days by acute management practices. Results: Most SRCs (n = 12,311 [72.1%]) had complete initial evaluation by an AT. Boys had an AT evaluation in 75.5% (n = 2860/3787) of practice-related and 74.8% (n = 5551/7423) of competition-related events. Girls had an AT evaluation in 61.3% (n = 1294/2110) of practice-related and 69.3% (n = 2606/3761) of competition-related events. In sex-comparable sports (n = 6501), there was no difference between boys (n = 1654/2455 [67.4%]) and girls (n = 2779/4046 [68.7%]) having an AT involved in the first evaluation (χ2 = 1.21; P = .27). Notably, 25.3% of girls’ SRCs were evaluated by a coach alone, and we observed differences in personnel in initial evaluations by sport. The odds of immediate removal were higher when an AT made the initial evaluation (OR, 2.8 [95% CI, 2.54-3.08]). The odds of prolonged RTS >21 days was lower for those with an AT in the initial evaluation (OR, 0.74 [95% CI, 0.65-0.84]) adjusting for significant factors from univariate analyses, boys relative to girls (OR, 0.85 [95% CI, 0.76-0.96]), specialty care relative to PCP (OR, 2.16 [95% CI, 1.90-2.46]), specialty care relative to urgent or ready care (OR, 0.99 [95% CI, 0.82-1.22]) concussion history (OR, 1.41 [95% CI, 1.22-1.63]), and removal from activity (OR, 0.90 [95% CI, 0.78-1.05]). Conclusion: This study found variability in personnel involved in initial SRC evaluations, with higher percentages of athletes with SRCs having ATs make the initial evaluation during competitive events. There was no association between sex and AT involvement in comparable sports. There was an association between prolonged RTS and AT involvement, sex, concussion history, and location of follow-up care.

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mentioning

confidence: 99%

Acute Sport-Related Concussion Management and Return to Sport Time in High School Athletes

Bretzin,

Zynda,

Pollard-McGrandy

et al. 2024

Am J Sports Med

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Commentary: The Florida Youth Concussion Law: A Survey-Based Observational Study of Physician Practices and Their Legislative Awareness

2019

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Integrating Neuropsychology Services in a Multidisciplinary Concussion Clinic

Baker

Willer

Leddy

2019

Journal of Head Trauma Rehabilitation

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Objective: To describe the integration of neuropsychology services in a multidisciplinary concussion clinic and provide descriptive information on patients, services, and initial health status. Setting: A university-based outpatient sports medicine concussion clinic. Participants: A consecutive sample of 338 patients ages 8 to 84 years (median 23.5 years, 35% 13-18 years), 49.1% male, seen between 2014 and 2018. Patients' injuries included sports 42%, work 28.4%, and vehicular 12.1% and 48.5% were students. Design: Descriptive statistics with group comparisons. Main Measures: 12-Item Short Form Health Survey (SF-12) T scores (mean = 50, SD = 10) referenced to US population. Results: Half of the patients were seen within 24 days of their injury and showed reduced physical functioning (40.2) and average mental (emotional) functioning (48.8). Patients seen after 24 days showed even more reduced physical functioning (33.9) and reduced mental functioning (41.0), both P < .0001. Average treatment time was also longer, 88.1 (173.9) versus 186.8 (211.1) days, P < .0001. Two-thirds of patients were referred for cervical or vestibular physical therapy at their initial visit. Conclusion: Early referral for specialized care, including neuropsychology services, may be beneficial.

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Sports-Related Concussions in Children

Cited by 4 publications

References 14 publications

Acute Sport-Related Concussion Management and Return to Sport Time in High School Athletes

Acute Sport-Related Concussion Management and Return to Sport Time in High School Athletes

Commentary: The Florida Youth Concussion Law: A Survey-Based Observational Study of Physician Practices and Their Legislative Awareness

Integrating Neuropsychology Services in a Multidisciplinary Concussion Clinic

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