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Annual trends in follow-up visits for paediatricpediatric concussion in emergency departments and doctors’ offices in ontario, canada between 2003–2013
  1. Liraz Fridman1,
  2. Michal Scolnik2,
  3. Alison Macpherson1,2,
  4. Linda Rothman1,
  5. Astrid Guttmann2,3,
  6. Anne Grool4,
  7. Daniel Rodriguez Duque2,
  8. Roger L Zemek4,5
  1. 1York University, Toronto, Canada
  2. 2Institute for Clinical Evaluative Sciences
  3. 3Hospital for Sick Children, Department of Pediatrics, University of Toronto, Toronto, Canada
  4. 4Childrens Hospital of Eastern Ontario Research Institute, Ottawa, Canada
  5. 5Department of Pediatric Emergency Medicine, University of Ottawa, Ottawa, Canada


Background Over the past ten years, ED and physician office visits for paediatric concussion have more than quadrupled. Current concussion management guidelines recommend follow-upand clearance by a physician prior to resumption of contact activities. However, compliance with recommended follow-up is not well documented in the literature.

Objective To examine trends in follow-up visits in accordance with current recommended guidelines for children with concussion.

Design Retrospective population-based study.

Setting Children and youth presenting to emergency departments (EDs) and doctors’ offices with concussion over a 10-year time period (2003–2013) in Ontario, Canada.

Outcome measures We examined the percentage of children and youth who were seen for follow-up visit post-concussion. Trends in the percent of children with a follow-up visit following an index visit to either a doctor’s office or an ED were reported.

Main results The proportion of children and youth assessed for concussion follow-up (N=45,150) has increased significantly (p<0.0001). In 2003, only 1010 of 7170 (14.2%) patients with an index visit for concussion had follow-up assessment; in 2009, 2733 of 10,134 (27.0%) had a follow-up visit, and by 2013, 11,806 of 21,681 (54.5%) received follow-up care.

Conclusions Despite increasing trends in the proportion of children being examined for concussion follow-up over a 10-year period, nearly half of all children with an index visit for concussion still do not receive follow-up assessment. This suggests that ongoing efforts to improve compliance with recommended guidelines will be important.

Competing interests None.

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