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Scarneo-Miller SE, Hosokawa Y, Drezner JA, Hirschhorn RM, Conway DP, Elkins GA, Hopper MN, Strapp EJ. National Athletic Trainers' Association Position Statement: Emergency Action Plan Development and Implementation in Sport. J Athl Train 2024; 59:570-583. [PMID: 38918009 PMCID: PMC11220767 DOI: 10.4085/1062-6050-0521.23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/27/2024]
Abstract
OBJECTIVE An emergency action plan (EAP) is a written document detailing the preparations and on-site emergency response of health care professionals and other stakeholders to medical emergencies in the prehospital setting. The EAP is developed to address any type of catastrophic injury response and should not be condition specific. The objective of this National Athletic Trainers' Association position statement is to provide evidence-based and consensus-based recommendations for developing and implementing an EAP for sports settings. METHODS These recommendations were developed by a multidisciplinary expert panel that performed (1) a comprehensive review of existing EAP evidence, (2) a modified Delphi process to define consensus recommendations, and (3) a strength of recommendation taxonomy determination for each recommendation. RESULTS An EAP is an essential tool designed to facilitate emergency preparedness and an efficient, coordinated emergency response during an athletic event. A comprehensive EAP should consider modes to optimize patient outcomes, the various stakeholders needed to develop the plan, the factors influencing effective implementation of the EAP, and the roles and responsibilities to ensure a structured response to a catastrophic injury. CONCLUSIONS These evidence-informed recommendations outline the necessary steps for emergency planning and provide considerations for the immediate management of patients with catastrophic injuries. Increasing knowledge and implementation of the EAP to manage patients with catastrophic injuries improves the overall response and decreases errors during an emergency.
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Weber Rawlins ML, Valovich McLeod TC. Concussion education perceptions among secondary school athletic trainers. Brain Inj 2023; 37:468-477. [PMID: 36939261 DOI: 10.1080/02699052.2023.2191009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/21/2023]
Abstract
PURPOSE Describe concussion education perceptions among secondary school athletic trainers and determine the relationship between education program characteristics and perceived effectiveness. METHODS Two hundred and three participants completed at least one survey item (age = 35.2 ± 9.4 years; male = 27.6%). We used descriptive statistics to describe concussion education characteristics and point out biserial correlations to determine if relationships existed between concussion education characteristics and perceived effectiveness. RESULTS The most frequently used mandated concussion education programs were informational handouts created by the state interscholastic association, the Centers for Disease Control and Prevention's (CDC) Heads Up materials, and the National Federation of State High School Athletic Association's materials. The CDC's Heads Up materials, handouts created by the state interscholastic association, and in-person presentations created by respondents were the most frequent concussion educational programs utilized by respondents who indicated no specific program mandated. Educational programs that were engaging increased perceived effectiveness (n = 131, rpb = 0.31,p < 0.001). CONCLUSIONS Our results highlight that materials created by state interscholastic association and the CDC's Heads Up program among others are utilized to satisfy mandates and are perceived to be moderately effective, especially when perceived to be engaging. These results can help guide future studies to examine specific educational tools and administration strategies to determine effectiveness on concussion disclosure.
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Affiliation(s)
| | - Tamara C Valovich McLeod
- Department of Interdisciplinary Health Sciences, A.T. Still University, Mesa,AZ, USA.,School of Osteopathic Medicine in Arizona, A.T. Still University, Mesa, AZ, USA
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Corwin DJ, Grady MF, Master CL, Joffe MD, Zonfrillo MR. Evaluation and Management of Pediatric Concussion in the Acute Setting. Pediatr Emerg Care 2021; 37:371-379. [PMID: 34180858 DOI: 10.1097/pec.0000000000002498] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
ABSTRACT Concussion, a type of mild traumatic brain injury, is a common injury encountered by providers caring for pediatric patients in the emergency department (ED) setting. Our understanding of the pathophysiologic basis for symptom and recovery trajectories for pediatric concussion continues to rapidly evolve. As this understanding changes, so do recommendations for optimal management of concussed youth. As more and more children present to EDs across the country for concussion, it is imperative that providers caring for children in these settings remain up-to-date with diagnostic recommendations and management techniques. This article will review the definition, epidemiology, pathophysiology, diagnosis, and management of pediatric concussion in the ED setting.
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Affiliation(s)
- Daniel J Corwin
- From the Attending Physician, Division of Emergency Medicine, Children's Hospital of Philadelphia
| | - Matthew F Grady
- Attending Physician, Sports Medicine and Performance Center, Children's Hospital of Philadelphia, Philadelphia, PA
| | - Christina L Master
- Attending Physician, Sports Medicine and Performance Center, Children's Hospital of Philadelphia, Philadelphia, PA
| | - Mark D Joffe
- From the Attending Physician, Division of Emergency Medicine, Children's Hospital of Philadelphia
| | - Mark R Zonfrillo
- Attending Physician, Departments of Emergency Medicine and Pediatrics, Alpert Medical School of Brown University and Hasbro Children's Hospital, Providence, RI
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Sullivan L, Newton A, Shi J, Chang TJ, Yang J. Concussion-Related Health Care Utilization Among Medicaid Insured Children in Ohio: Rural and Urban Differences. J Rural Health 2021; 37:479-486. [PMID: 32744752 PMCID: PMC10949251 DOI: 10.1111/jrh.12484] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
PURPOSE The current study examines rural-urban differences in trends in rates and type of concussion-related health care utilization over time from 2008 to 2016 among Medicaid insured children in Ohio. METHODS We analyzed Medicaid claims for health care utilization for diagnosed concussions among children aged ≤18 years between April 1, 2008, and December 31, 2016. We compared the trends in rates of concussion-related health care utilization between children who lived in rural and urban areas using Poisson regressions. We examined trends in the type of concussion-related health care utilization by location of residence using linear regressions. FINDINGS We found a significant increase in health care utilization for concussion over time, with rates of treated concussion consistently higher in rural children compared to urban children (P < .0001) throughout the study period. Although initial care at the Emergency Department (ED) remained the most common type of initial concussion-related health care utilization for rural children throughout the study period, the most common type of initial care sought by urban children shifted over time from the ED to primary care providers (PCPs). For both rural and urban children, PCPs remained the most common type of follow-up care sought throughout the study period, with no significant rural-urban differences in the trends of follow-up care sought through PCPs over time. CONCLUSIONS We observed significant rural-urban differences in the trends in rates and types of concussion-related health care utilization over time from 2008 to 2016. Future studies are needed to further our understanding of the effect of these observed rural-urban differences on concussion recovery.
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Affiliation(s)
- Lindsay Sullivan
- Center for Injury Research and Policy, The Research Institute at Nationwide Children's Hospital, Columbus, Ohio
| | - Alison Newton
- Center for Injury Research and Policy, The Research Institute at Nationwide Children's Hospital, Columbus, Ohio
| | - Junxin Shi
- Center for Injury Research and Policy, The Research Institute at Nationwide Children's Hospital, Columbus, Ohio
| | - Teng-Jen Chang
- Center for Injury Research and Policy, The Research Institute at Nationwide Children's Hospital, Columbus, Ohio
| | - Jingzhen Yang
- Center for Injury Research and Policy, The Research Institute at Nationwide Children's Hospital, Columbus, Ohio
- Department of Pediatrics, The Ohio State University, College of Medicine, Columbus, Ohio
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5
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Knell G, Caze T, Burkhart SO. Evaluation of the vestibular and ocular motor screening (VOMS) as a prognostic tool for protracted recovery following paediatric sports-related concussion. BMJ Open Sport Exerc Med 2021; 7:e000970. [PMID: 33868706 PMCID: PMC7996664 DOI: 10.1136/bmjsem-2020-000970] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/15/2021] [Indexed: 12/02/2022] Open
Abstract
Objective To understand the relationship between initial vestibular and ocular motor screening (VOMS) and recovery time, and the utility of VOMS to screen for protracted recovery in youth/adolescent patients with sport-related concussion (SRC). Methods Participants (8–18 years) who were diagnosed with an SRC within 7 days of the injury were administered the VOMS test by certified medical personnel. Recovery time (days) and protracted recovery (>30 days) were the primary outcomes. Multivariable regression models were used to evaluate the association between VOMS symptom provocation and (1) recovery time (days) and (2) protracted recovery. Measures of VOMS validity, predictive ability and receiver operator curves were used to assess VOMS as a prognostic tool to accurately classify a normal/protracted recovery. Results After adjustment, any symptom provocation across all VOMS domains was associated (p<0.05) with greater recovery time, except the convergence test (p=0.08) in females. All VOMS test thresholds (≥1 to ≥10) in males and (≥1 to ≥5) in females were associated (p<0.05) with recovery time. However, the VOMS test performed poorly among males (receiver operating characteristic (ROC) area=0.66) and failed among females (ROC area=0.56) as a prognostic tool to identify those that will have a normal/protracted recovery. Conclusion In this sample, overall, the VOMS test was associated with recovery time (days); however, the VOMS was not a valid stand-alone prognostic tool to identify a delayed recovery, but may be useful in combination with other concussion symptomology assessments. Future studies should confirm these findings in larger samples while taking into consideration other comorbid factors that may influence recovery time.
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Affiliation(s)
- Gregory Knell
- Center for Pedatric Population Health, Children's Health System of Texas and University of Texas Health Science Center at Houston, Dallas, TX, USA.,Epidemiology, Human Genetics, and Environmental Sciences, University of Texas Health Science Center at Houston, Dallas, TX, USA.,Andrews Institute for Orthopaedics and Sports Medicine, Children's Health System of Texas, Plano, TX, USA
| | - Todd Caze
- Andrews Institute for Orthopaedics and Sports Medicine, Children's Health System of Texas, Plano, TX, USA.,Department of Psychiatry, University of Texas Southwestern Medical School, Dallas, Texas, USA
| | - Scott O Burkhart
- Andrews Institute for Orthopaedics and Sports Medicine, Children's Health System of Texas, Plano, TX, USA
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Alberts JL, Modic MT, Udeh BL, Zimmerman N, Cherian K, Lu X, Gray R, Figler R, Russman A, Linder SM. A Technology-Enabled Concussion Care Pathway Reduces Costs and Enhances Care. Phys Ther 2020; 100:136-148. [PMID: 31584666 DOI: 10.1093/ptj/pzz141] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2019] [Revised: 12/21/2018] [Accepted: 05/05/2019] [Indexed: 11/15/2022]
Abstract
BACKGROUND The standardization of care along disease lines is recommended to improve outcomes and reduce health care costs. The multiple disciplines involved in concussion management often result in fragmented and disparate care. A fundamental gap exists in the effective utilization of rehabilitation services for individuals with concussion. PURPOSE The purpose of this project was to (1) characterize changes in health care utilization following implementation of a concussion carepath, and (2) present an economic evaluation of patient charges following carepath implementation. DESIGN This was a retrospective cohort study. METHODS A review of electronic medical and financial records was conducted of individuals (N = 3937), ages 18 to 45 years, with primary diagnosis of concussion who sought care in the outpatient or emergency department settings over a 7-year period (2010-2016). Outcomes including encounter length, resource utilization, and charges were compared for each year to determine changes from pre- to post-carepath implementation. RESULTS Concussion volumes increased by 385% from 2010 to 2015. Utilization of physical therapy increased from 9% to 20% while time to referral decreased from 72 to 23 days post-injury. Utilization of emergency medicine and imaging were significantly reduced. Efficient resource utilization led to a 20.7% decrease in median charges (estimated ratio of means [CI] 7.72 [0.53, 0.96]) associated with concussion care. LIMITATIONS Encounter lengths served as a proxy for recovery time. CONCLUSIONS The implementation of the concussion carepath was successful in optimizing clinical practice with respect to facilitating continuity of care, appropriate resource utilization, and effective handoffs to physical therapy. The utilization of enabling technology to facilitate the collection of common outcomes across providers was vital to the success of standardizing clinical care without compromising patient outcomes.
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Affiliation(s)
- Jay L Alberts
- Department of Biomedical Engineering, Cleveland Clinic Foundation, 9500 Euclid Avenue, ND-20, Cleveland, OH 44195 (USA); Center for Neurological Restoration, Cleveland Clinic Foundation; Office of Clinical Transformation, Cleveland Clinic Foundation; and Concussion Center, Cleveland Clinic Foundation
| | - Michael T Modic
- Office of Clinical Transformation, Cleveland Clinic Foundation
| | - Belinda L Udeh
- Office of Clinical Transformation, Cleveland Clinic Foundation; and Neurological Institute Center for Outcomes Research, Cleveland Clinic Foundation
| | | | - Kay Cherian
- Department of Biomedical Engineering, Cleveland Clinic Foundation
| | - Xiaoyang Lu
- Office of Clinical Transformation, Cleveland Clinic Foundation
| | - Robert Gray
- Concussion Center, Cleveland Clinic Foundation
| | | | | | - Susan M Linder
- Department of Biomedical Engineering, Cleveland Clinic Foundation; and Concussion Center, Cleveland Clinic Foundation
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Kerr ZY, Chandran A, Nedimyer AK, Arakkal A, Pierpoint LA, Zuckerman SL. Concussion Incidence and Trends in 20 High School Sports. Pediatrics 2019; 144:peds.2019-2180. [PMID: 31615955 DOI: 10.1542/peds.2019-2180] [Citation(s) in RCA: 89] [Impact Index Per Article: 17.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/07/2019] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Ongoing monitoring of concussion rates and distributions is important in assessing temporal patterns. Examinations of high school sport-related concussions need to be updated. This study describes the epidemiology of concussions in 20 high school sports during the 2013-2014 to 2017-2018 school years. METHODS In this descriptive epidemiology study, a convenience sample of high school athletic trainers provided injury and athlete exposure (AE) data to the National High School Sports-Related Injury Surveillance Study (High School Reporting Information Online). Concussion rates per 10 000 AEs with 95% confidence intervals (CIs) and distributions were calculated. Injury rate ratios and injury proportion ratios examined sex differences in sex-comparable sports (soccer, basketball, baseball and softball, cross country, track, and swimming). We also assessed temporal trends across the study period. RESULTS Overall, 9542 concussions were reported for an overall rate of 4.17 per 10 000 AEs (95% CI: 4.09 to 4.26). Football had the highest concussion rate (10.40 per 10 000 AEs). Across the study period, football competition-related concussion rates increased (33.19 to 39.07 per 10 000 AEs); practice-related concussion rates decreased (5.47 to 4.44 per 10 000 AEs). In all sports, recurrent concussion rates decreased (0.47 to 0.28 per 10 000 AEs). Among sex-comparable sports, concussion rates were higher in girls than in boys (3.35 vs 1.51 per 10 000 AEs; injury rate ratio = 2.22; 95% CI: 2.07 to 2.39). Also, among sex-comparable sports, girls had larger proportions of concussions that were recurrent than boys did (9.3% vs 6.4%; injury proportion ratio = 1.44; 95% CI: 1.11 to 1.88). CONCLUSIONS Rates of football practice-related concussions and recurrent concussions across all sports decreased. Changes in concussion rates may be associated with changes in concussion incidence, diagnosis, and management. Future research should continue to monitor trends and examine the effect of prevention strategies.
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Affiliation(s)
- Zachary Y Kerr
- Department of Exercise and Sport Science, and .,Matthew Gfeller Sport-Related Traumatic Brain Injury Research Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Avinash Chandran
- Department of Exercise and Sport Science, and.,Matthew Gfeller Sport-Related Traumatic Brain Injury Research Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Aliza K Nedimyer
- Human Movement Science Curriculum.,Matthew Gfeller Sport-Related Traumatic Brain Injury Research Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Alan Arakkal
- Department of Epidemiology, Anschutz Medical Campus, University of Colorado Denver, Aurora, Colorado
| | | | - Scott L Zuckerman
- Department of Neurological Surgery, and Sports Concussion Center, School of Medicine, Vanderbilt University, Nashville, Tennessee
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8
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Keays G, Friedman D, Gagnon I, Beaudin M. Determining the accuracy of the Canadian Hospitals Injury Reporting and Prevention Program for the representation of the rates of mild traumatic brain injuries in Quebec. Health Promot Chronic Dis Prev Can 2019; 39:291-297. [PMID: 31729311 PMCID: PMC6876650 DOI: 10.24095/hpcdp.39.11.01] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
INTRODUCTION The recent rise in mild traumatic brain injuries (mTBI) in the pediatric population has been documented by many studies in Canada and the United States. The objective of our study was to compare mTBI rates from the Canadian Hospital Injury Reporting and Prevention Program (CHIRPP) in Montréal with population-based rates (Quebec mTBI rates). METHODS We calculated CHIRPP's mTBI rates via two methods: (1) using all CHIRPP injuries as the denominator; and (2) using the number of children aged 0 to 17 years living within 5 km of either of two CHIRPP centres in Montréal as the denominator. We plotted CHIRPP's mTBI rates against the provincial rates and compared them according to sex and age. RESULTS Whether using all CHIRPP injuries or the number of children aged 0 to 17 years living within 5 km of either CHIRPP centre in Montreal as the denominator, CHIRPP paralleled the fluctuations seen in Quebec's rates between 2003 and 2016. When stratifying by sex and age, CHIRPP was better at estimating the population-based rates for the youngest (0 to 4 years) and the oldest (13 to 17 years) age groups. CONCLUSION CHIRPP in Montréal proved a valid tool for estimating the variations in rates of mTBI in the population. This suggests that CHIRPP could also be used to estimate population-based rates of other types of injuries.
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Affiliation(s)
- Glenn Keays
- Canadian Hospitals Injury Reporting and Prevention Program (CHIRPP), The Montreal Children's Hospital, McGill University Health Centre, Montréal, Quebec, Canada
- Montreal Children's Hospital Trauma Centre, McGill University Health Centre, Montréal, Quebec, Canada
| | - Debbie Friedman
- Canadian Hospitals Injury Reporting and Prevention Program (CHIRPP), The Montreal Children's Hospital, McGill University Health Centre, Montréal, Quebec, Canada
- Montreal Children's Hospital Trauma Centre, McGill University Health Centre, Montréal, Quebec, Canada
- Department of Pediatrics & Pediatric Surgery, Faculty of Medicine, McGill University, Montréal, Quebec, Canada
| | - Isabelle Gagnon
- Department of Pediatrics & Pediatric Surgery, Faculty of Medicine, McGill University, Montréal, Quebec, Canada
- School of Physical and Occupational Therapy, Faculty of Medicine, McGill University, Montréal, Quebec, Canada
| | - Marianne Beaudin
- Centre hospitalier universitaire mère-enfant Sainte-Justine, Montréal, Quebec, Canada
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Abstract
Concussions have gained attention in medical literature, legal literature, and lay media over the past several years as a public health affecting children, particularly those who do not improve in the first few days after an injury. We discuss strategies for acute management immediately after a concussion and an introduction to medical and non-medical options for treatment of the complex symptoms that persist in some patients with concussions. We examine the role of rest and exercise during recovery. We briefly discuss the role of the multidisciplinary approach to concussion in a setting that engages multiple specialists. Finally, we address policy changes related to sport-concussions and their efficacy in improving long term outcomes.
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Affiliation(s)
- Karameh Kuemmerle
- Neurology Foundation, Boston Children's Hospital, 300 Longwood Ave, Boston, MA, 02115; Harvard Medical School, Boston, MA.
| | - William P Meehan
- Harvard Medical School, Boston, MA; Division of Sports Medicine, Boston Children's Hospital, Boston, MA.
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10
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Hardesty W, Singichetti B, Yi H, Leonard JC, Yang J. Characteristics and Costs of Pediatric Emergency Department Visits for Sports- and Recreation-Related Concussions, 2006-2014. J Emerg Med 2019; 56:571-579. [PMID: 30857833 DOI: 10.1016/j.jemermed.2019.01.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2018] [Revised: 12/19/2018] [Accepted: 01/08/2019] [Indexed: 12/21/2022]
Abstract
BACKGROUND Although concussion-related emergency department (ED) visits increased after the passage of concussion laws, little is known about how the laws may disproportionately impact ED utilization and associated health care costs among children in different demographic groups. OBJECTIVE Our aim was to examine the patient and clinical characteristics of pediatric ED visits and associated health care costs for sports- and recreation-related concussions (SRRCs) before and after concussion law enactment. METHODS We retrospectively analyzed ED visits for SRRCs by children ages 5-18 years between 2006 and 2014 in the Pediatric Health Information System database (n = 123,220). ED visits were categorized as "pre-law," "immediate post-law," and "post-law" according to the respective state concussion law's effective date. Multinomial logistic regression models were used to assess the impact of the law on ED utilization. RESULTS The majority of visits were by males (n = 83,208; 67.6%), children aged 10-14 years (n = 49,863; 40.9%), and privately insured patients (n = 62,376; 50.6%). Female sex, older age, and insured by Medicaid/Medicare were characteristics associated with increased ED visits during the immediate post-law and post-law periods compared to their counterparts. A significant decrease in proportion of imaging use was observed from pre-law to post-law (adjusted odds ratio 0.49; 95% confidence interval 0.47-0.50; p < 0.0001). While annual adjusted costs per ED visits decreased, annual total adjusted costs per hospital for SRRCs increased from pre-law to post-law (p < 0.0001). CONCLUSIONS Concussion laws might have impacted pediatric concussion-related ED utilization, with increased annual total adjusted costs. These results may have important implications for policy interventions and their effects on health care systems.
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Affiliation(s)
- Walter Hardesty
- Center for Injury Research and Policy, The Research Institute at Nationwide Children's Hospital, Columbus, Ohio; Department of Pediatrics, College of Medicine, The Ohio State University, Columbus, Ohio
| | - Bhavna Singichetti
- Center for Injury Research and Policy, The Research Institute at Nationwide Children's Hospital, Columbus, Ohio
| | - Honggang Yi
- Center for Injury Research and Policy, The Research Institute at Nationwide Children's Hospital, Columbus, Ohio; Department of Biostatistics, School of Public Health, Nanjing Medical University, Nanjing, China
| | - Julie C Leonard
- Center for Injury Research and Policy, The Research Institute at Nationwide Children's Hospital, Columbus, Ohio; Department of Pediatrics, College of Medicine, The Ohio State University, Columbus, Ohio
| | - Jingzhen Yang
- Center for Injury Research and Policy, The Research Institute at Nationwide Children's Hospital, Columbus, Ohio; Department of Pediatrics, College of Medicine, The Ohio State University, Columbus, Ohio
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11
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Abstract
There has been a dramatic rise in the use of large-scale health administrative databases to investigate clinical outcomes within sports medicine over the past few years. Although these data sets identify large numbers of patients, allowing for the investigation of regional trends, health care utilization, and outcomes of surgical intervention, they were not designed with the intention of answering clinical questions. Recognizing the methodological limitations associated with these databases is prudent to avoid propagating spurious conclusions. This article offers an overview of the administrative databases commonly used within the orthopedic sports medicine literature and provides key principles for their critical appraisal.
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Affiliation(s)
- David Wasserstein
- Division of Orthopaedic Surgery, Sunnybrook Health Sciences Centre, University of Toronto, MG323 - 2075 Bayview Avenue, Toronto, Ontario M4N 3M5, Canada.
| | - Ujash Sheth
- Division of Orthopaedic Surgery, University of Toronto, MG323 - 2075 Bayview Avenue, Toronto, Ontario M4N 3M5, Canada
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12
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Lystad RP, Strotmeyer SJ. Concussion knowledge, attitudes and reporting intention among adult competitive Muay Thai kickboxing athletes: a cross-sectional study. Inj Epidemiol 2018; 5:25. [PMID: 29888376 PMCID: PMC5994390 DOI: 10.1186/s40621-018-0155-x] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2018] [Accepted: 04/30/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Muay Thai kickboxing is a full-contact combat sport with a high incidence of head trauma, yet little is known about these athletes' concussion knowledge and attitudes. This study aims to describe and quantify concussion knowledge, attitudes, and reporting intention among adult competitive Muay Thai kickboxing athletes. RESULTS This cross-sectional study comprised 193 competitive Muay Thai kickboxing athletes aged ≥18 years registered with the Thai Boxing Association Sanctioning Authority. The mean concussion knowledge score was 19.5 (SD 2.3) out of 25, the mean concussion attitudes score was 62.7 (SD 7.4) out of 75, and 134 (69.4%) of respondents indicated that they were likely to report concussion symptoms. No significant predictors of concussion knowledge, attitudes, or reporting intention were revealed. CONCLUSIONS Competitive Muay Thai kickboxing athletes appear to have reasonably good concussion knowledge, attitudes, and reporting intention; however, there is still room for further improvement. It is recommended that concussion education programs based on current best evidence are made available to all kickboxing athletes and coaches.
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Affiliation(s)
- Reidar P Lystad
- Australian Institute of Health Innovation, Macquarie University, Level 6, 75 Talavera Road NSW, Sydney, 2109, Australia.
| | - Stephen J Strotmeyer
- Division of General Surgery and Trauma, Department of Surgery, University of Pittsburgh Medical Center, Children's Hospital of Pittsburgh of UPMC, Pittsburgh, Pennsylvania, USA
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13
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Hassen GW, Tinnesz N, Popkin M, Mirkovic J, Pingle A, Umandap C, Sethuraman V, Warren R, Villa JAC, Kalantari H. Concussion awareness among children and their care givers. Am J Emerg Med 2018; 36:2328-2331. [PMID: 29752164 DOI: 10.1016/j.ajem.2018.04.048] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2018] [Revised: 04/19/2018] [Accepted: 04/20/2018] [Indexed: 02/04/2023] Open
Affiliation(s)
- Getaw Worku Hassen
- Department of Emergency Medicine, Metropolitan Hospital Center, United States.
| | - Nicholas Tinnesz
- Department of Emergency Medicine, Metropolitan Hospital Center, United States
| | - Michelle Popkin
- Department of Emergency Medicine, Metropolitan Hospital Center, United States
| | | | - Abhishek Pingle
- Case Western Reserve University, Cleveland, OH, United States
| | - Christine Umandap
- Department of Pediatrics, Metropolitan Hospital Center, United States
| | | | | | | | - Hossein Kalantari
- Department of Emergency Medicine, Metropolitan Hospital Center, United States
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