In a decade-long study, Canadian researchers found that more than two-thirds of children and teens in Ontario with acute concussions did not receive medical follow-up care or clearance as recommended by current guidelines.
“Despite improvement over the past several years, the rate of follow-up visits after a pediatric concussion diagnosis remain unacceptably low.” said senior author Dr. Roger Zemek, director of clinical research at the Children’s Hospital of Eastern Ontario.
“This reinforces the ongoing need to ensure that the latest concussion guidelines are implemented broadly in order to standardize the approach to concussion diagnosis and management.”
For the study, Professor Alison Macpherson in the Faculty of Health, School of Kinesiology & Health Science at York University, and former York University Ph.D. student Liraz Fridman, analyzed data from more than 120,000 children aged five to 19 years. The aim of the study was to investigate whether concussed youth go on to receive follow-up visits in accordance with the recommended guidelines.
The researchers looked at population-based data from the Institute for Clinical Evaluative Sciences (ICES) consisting of all concussion-related visits to emergency department and physician offices in Ontario from 2003-2013.
The team measured the percentage of children and youth seen for follow-up. Over the decade of the study, the findings reveal that there was an increase in the number of children who came in for follow-up care after being evaluated for a concussion before 2013.
In Ontario, concussion-related emergency department and office visits rates per 100,000 children have quadrupled from 2003 to 2013, with similar increases found in the United States. In 2003, 11 percent of children and teens were seen for a follow-up after sustaining a concussion and by 2013 that number jumped to 30 percent.
Still, over two-thirds did not receive follow-up care in accordance with international recommended guidelines.
“That two-thirds of children were still not being seen for follow-up was surprising considering that international recommendations have been in place since 2001,” said Fridman.
“A lack of sufficient follow-up care puts children and youth at risk for another concussion or more serious consequences,” added Macpherson.
The researchers say it is unclear why most concussed children do not receive adequate follow-up and treatment. However, the findings show the need for better education programs for health care professionals, parents, coaches, children, and youth which may help improve follow-up rates.
Source: York University