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Multi-disciplinary management of paediatricpediatric sports-related concussion: early experience of the pan am concussion program
  1. Kelly Russell1,2,3,
  2. Lesley Ritchie3,4,
  3. Patrick J McDonald5,
  4. Dean Cordingley3,6,
  5. Karen Reimer3,6,
  6. Richard Girardin3,6,
  7. Sara Vis6,
  8. Erin Selci1,2,
  9. Peter MacDonald7,
  10. Jeffrey Leiter2,3,7,
  11. Michael Ellis2,3,8
  1. 1Department of Pediatrics and Child Health, University of Manitoba, Winnipeg, MB, Canada
  2. 2Childrens Hospital Research Institute of Manitoba, Winnipeg, MB, Canada
  3. 3Canada North Concussion Network, Winnipeg, Canada
  4. 4Department of Clinical Health Psychology University of Manitoba, Winnipeg, MB, Canada
  5. 5University of British Columbia, Vancouver, British Columbia
  6. 6Pan Am Foundation, Winnipeg, Manitoba
  7. 7Department of Surgery, University of Manitoba, Winnipeg, Manitoba
  8. 8Departments of Surgery and Pediatrics and Child Health, University of Manitoba, Winnipeg, Manitoba.

Abstract

Objective Summarise clinical characteristics, outcomes, and healthcare resources and personnel needs of paediatric sports-related concussion (SRC) patients who were evaluated and managed at a multi-disciplinary paediatric concussion program.

Design Retrospective cohort study

Setting Paediatric, multi-disciplinary concussion clinic

Participants 423 paediatric SRC patients: 14.3 years (SD: 2.3), 59.6% males, 43.0% hockey-related, and 75.8% acute SRC

Interventions (or assessment of risk factors) Initial assessment and diagnosis by a neurosurgeon with the multi-disciplinary team completing Return-to-Play decision-making. On-site neurosurgeon, neuropsychologist, vestibulo-ocular therapist, and exercise physiologist and referrals to neurology and psychiatry

Outcome measures SRC diagnosis and recovery were defined by the 2013 Zurich Consensus Guidelines. Post-Concussion Syndrome was diagnosed using ICD-10 criteria of at least 3 symptoms at 30 days or more. Outcomes included demographic and injury data, healthcare resources and personnel utilised, and recovery

Main results Overall, 294 (69.5%) of SRC patients met the clinical criteria for recovery, 75 (17.7%) were lost to follow-up, 53 (12.5%) remained in treatment, and 1 died (0.2%). In acute patients, median time to initial consultation was 7 days (IQR: 5, 12). Median days to recovery among acute SRC patients with complete follow-up was 23 days (IQR: 15, 36) and 44.1% of acute SRC patients were diagnosed with PCS. 25.3% of SRC patients underwent at least one diagnostic imaging test and 32.6% received referral to another member of our multi-disciplinary clinical team.

Conclusions Youth received comprehensive care with access to appropriate diagnostic resources and multi-disciplinary collaboration of experts with national and provincially-recognised training in TBI

Competing interests None.

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