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J Pediatr. 2017 Feb;181:222-228.e2. doi: 10.1016/j.jpeds.2016.10.067. Epub 2016 Nov 11.

Annual and Seasonal Trends in Ambulatory Visits for Pediatric Concussion in Ontario between 2003 and 2013.

Author information

1
Division of Pediatric Emergency Medicine, Department of Pediatrics, University of Ottawa, Ottawa, Ontario, Canada; Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada. Electronic address: rzemek@cheo.on.ca.
2
Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada.
3
Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada.
4
School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada.
5
School of Kinesiology and Health Science, Faculty of Health, York University, Toronto, Ontario, Canada.
6
Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada; Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada; Division of Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, School of Epidemiology, Public Health and Preventive Medicine, University of Ottawa, Ottawa, Ontario, Canada.
7
Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada; Hospital for Sick Children, Department of Pediatrics, University of Toronto, Toronto, Ontario, Canada.
8
Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada; School of Kinesiology and Health Science, Faculty of Health, York University, Toronto, Ontario, Canada.

Abstract

OBJECTIVE:

To investigate annual and seasonal trends in physician office and emergency department (ED) visit rates for pediatric concussion in Ontario between 2003 and 2013.

STUDY DESIGN:

A retrospective, population-based study was conducted using linked health administrative data from all concussion-related visits to ED and physician office by children aged 5 through 18 years. Time series analysis was used to assess whether periodic components exist in the monthly number of concussion-related visits.

RESULTS:

Over the 11-year study period, there were 176 685 pediatric visits for concussion in EDs and physician offices in Ontario. Standardized concussion-related visits showed a 4.4-fold (95% CI 4.37-4.45) increase per 100 000 from 2003 to 2013, with nearly 35 000 total visits in 2013. Concussion-related visits demonstrated a steep increase from 2010 onward. The greatest increases in standardized visits were in females (6.3-fold, 95% CI 6.23-6.46 vs 3.6-fold, 95% CI 3.56-3.64 in males) and 13-18.99 year olds (5.0-fold, 95% CI 4.93-5.08 vs 4.1-fold, 95% CI 3.99-4.27 in 9-12 years and 2.3-fold, 95% CI 2.23-2.42 in 5-8 years). A strong seasonal variability (R2autoreg = 0.87, P < .01) in the number of concussion-related visits was present, with most occurring in fall and winter.

CONCLUSIONS:

Pediatric concussion-related ED and physician office visit rates have greatly increased in the last decade, particularly since 2010. Prevention strategies may be targeted at those most at risk and at seasonal-related activities carrying the greatest risk of concussion.

KEYWORDS:

adolescents; children; concussion; emergency; epidemiology; mild traumatic brain injury; primary care

PMID:
27843008
DOI:
10.1016/j.jpeds.2016.10.067
[Indexed for MEDLINE]

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