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Thomas E, Chih H, Thorne J, Fitzgerald M, Cowen G. A retrospective analysis of concussion and post-concussional syndrome diagnoses in Western Australian emergency departments. Injury 2024; 55:111333. [PMID: 38280260 DOI: 10.1016/j.injury.2024.111333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Revised: 12/03/2023] [Accepted: 01/13/2024] [Indexed: 01/29/2024]
Abstract
OBJECTIVE(S) To determine the rate of concussion diagnoses per capita recorded in hospital emergency departments in Western Australia (WA) from 2002-2018 for ICD-10-AM concussion diagnoses S06.00-S06.05, and post-concussional syndrome (PCS) (F07.2). DESIGN, SETTING AND ANALYSIS Retrospective analysis of hospital Emergency Department (ED) presentations and hospital admissions from all WA hospitals for all patients with an ICD-10-AM diagnosis code for concussion and post-concussional syndrome (PCS) over the period 2002-2018. Data pertaining to concussion and PCS presentations were extracted from the WA Department of Health Emergency Department Data Collection (EDDC). Total case numbers were aggregated by year (2002-2018) and regions of WA. MAIN OUTCOME MEASURES The rates of diagnoses were calculated based on the population in the specific region and expressed as incidence rate per 100,000 person-years. The overall trends of diagnoses across the regions were analysed using negative binomial regression models and expressed as incidence rate ratio (IRR) with the corresponding 95 % CI, whilst adjusting for region. Tests for linearity were also performed. RESULTS The rate of concussion diagnosis had significantly increased linearly over the years (p for trend: p < 0.001) whilst the rate of PCS diagnosis had significantly declined linearly over the same period (p for trend: p < 0.001). CONCLUSION There was significant increase in all-cause ICD-10-AM concussion diagnoses in WA emergency departments. To further clarify the incidence and prevalence of all-cause concussion in Australia, investigation must focus on truly reflective S06.0 codes and include data linkage to primary care data. Conversely PCS ED presentations reduced; whether this relates to a change in where presentations occur for management of such a diagnosis, improved early intervention or an alternative explanation warrants further investigation.
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Affiliation(s)
- Elizabeth Thomas
- School of Population Health, Faculty of Health Sciences, Curtin University, Kent Street, Bentley, Western Australia, 6102, Australia
| | - HuiJun Chih
- School of Population Health, Faculty of Health Sciences, Curtin University, Kent Street, Bentley, Western Australia, 6102, Australia
| | - Jacinta Thorne
- Curtin Health Innovation Research Institute, Curtin University, Kent Street, Bentley, Western Australia, 6012, Australia; Perron Institute for Neurological and Translational Science, Sarich Neuroscience Research, Institute Building, 8 Verdum Street, Nedlands, Western Australia, 6009, Australia; School of Allied Health, Faculty of Health Sciences, Curtin University, Kent Street, Bentley, Western Australia, 6012, Australia
| | - Melinda Fitzgerald
- Curtin Health Innovation Research Institute, Curtin University, Kent Street, Bentley, Western Australia, 6012, Australia; Perron Institute for Neurological and Translational Science, Sarich Neuroscience Research, Institute Building, 8 Verdum Street, Nedlands, Western Australia, 6009, Australia
| | - Gill Cowen
- School of Population Health, Faculty of Health Sciences, Curtin University, Kent Street, Bentley, Western Australia, 6102, Australia; Curtin Health Innovation Research Institute, Curtin University, Kent Street, Bentley, Western Australia, 6012, Australia; Curtin Medical School, Faculty of Health Sciences, Curtin University, Kent Street, Bentley, Western Australia, 6012, Australia.
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First-Aid System for Marathon Athletes Based on Telemedicine Technology. Appl Bionics Biomech 2022; 2022:3335225. [PMID: 36111170 PMCID: PMC9470358 DOI: 10.1155/2022/3335225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Revised: 07/16/2022] [Accepted: 07/25/2022] [Indexed: 11/18/2022] Open
Abstract
With the emphasis on sports in the region and the improvement of people's living standards, more and more people participate in various sports and activities including marathon, so that more and more cities are hosting or even vying for it. With the marathon, not only the joy of successfully holding the event, but also the pain of the contestants and even the sadness of sudden death. In order to reduce the occurrence of such problems, this paper studies the emergency system of marathon runners based on telemedicine technology. The experimental results show that the research on first-aid bears for athletes based on telemedicine technology can save a lot of time and managers, improve the efficiency of first aid by 3.45%, and provide first-aid services for injured athletes at the first time, so as to ensure the health of athletes, ensuring the confidence and well-being of athletes participating in the marathon.
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Kinmond S, Sullivan KA, Jaganathan KS. Research Letter: Concussion Knowledge Is Difficult to Predict From Self-Reported Exposure, Sports Participation, and Education. J Head Trauma Rehabil 2022; 37:272-277. [PMID: 34570025 DOI: 10.1097/htr.0000000000000726] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES Increasing concussion knowledge could contribute to improving injury outcomes. Understanding the predictors of concussion knowledge could determine the areas of educational need. This study examined whether individual factors, prior brain injury, prior concussion education, and contact-sports participation predicted concussion knowledge. DESIGN AND SETTING Cross-sectional study with recruitment of community volunteers. PARTICIPANTS An online survey was completed by 525 adults, 443 of whom provided useable responses. MAIN MEASURES The respondents provided background information and completed the Concussion Knowledge Index from the Rosenbaum Concussion Knowledge and Attitudes Survey (RoCKAS). RESULTS On average, the participants answered 19.8 out of 25 items correctly. A multiple regression model with demographic, injury, and sport-related variables did not significantly predict concussion knowledge. CONCLUSION This community sample had higher than expected concussion knowledge (restricted range), but some important misconceptions were still present. The model reflecting a combination of self-reported factors did not predict concussion knowledge. The implications for concussion education are discussed, including the need for targeted education to address specific misconceptions.
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Affiliation(s)
- Sally Kinmond
- School of Psychology and Counselling, Queensland University of Technology, Brisbane, Australia (Ms Kinmond and Mr Jaganathan); and School of Psychology and Counselling, and Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia (Dr Sullivan)
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Taubman B, Michael Luciani A, Gealt DB, Drake TP, Cochetti P, Farrar JT. The care of the concussed pediatric patient prior to presentation to primary care pediatrician versus concussion specialists: Implications for management. JOURNAL OF CONCUSSION 2021. [DOI: 10.1177/2059700221998921] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Objective Absent adequate randomized control trials to inform appropriate treatment for concussion in pediatric patients, guidelines have been developed based on expert opinion and observational data that may not apply to all groups. This study examines differences in the previous clinical care between concussed patients who present in pediatric practice and specialty clinics. Differences found might influence treatment recommendations for each setting. Study design Prospective data collected from a pediatric practice in 2011 to 2013 were compared to chart review data from two specialty clinics between 2015 and 2017. In all three groups patients 11–19 years of age with an ICD9 billing code for concussion were included if they met the 4th International Consensus definition of concussion. Patients were excluded if hospitalized or had abnormal CNS imaging. Results The time between injury and presentation was substantially longer in specialty clinic patients versus those seen in the primary pediatric care office. (median 10 vs. 2 days-p < 0.001) Primary care patients presenting had higher rates of immediate rest after injury, 61.4% vs 27.9% (p < 0.001). More specialty clinic patients had been seen in the emergency departments prior to presentation (47.5% vs. 18.8% p < 0.001) regardless of rest status at presentation to the office. Conclusion Several differences in previous clinical care between the groups were found. These included the time of presentation from injury, rates of cognitive rest both immediate and non-immediate, and emergency department visits. These differences may have implications for management recommendations. Accordingly, the appropriate treatment for patients seen by the primary pediatric care physicians may be different from those referred to specialty care. Given these findings randomized controlled trails should be conducted independently in both groups of patients.
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Affiliation(s)
- Bruce Taubman
- Advocare Cherry Hill Pediatric Group, Cherry Hill, New Jersey, USA
- Perelman School of Medicine at the University of Pennsylvania, Department of Pediatrics, Philadelphia, Pennsylvania
| | | | - David B Gealt
- Cooper Bone and Joint Institute, Division of Sports Medicine, Cooper University Hospital, Camden, USA
| | - Thomas P Drake
- Department of Pediatric Neurology, Division of Pediatric Rehabilitation, Cooper University Hospital, Camden, USA
| | - Philip Cochetti
- Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, USA
| | - John T Farrar
- Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, USA
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Clarke C, Anderson V, Babl FE, Rausa VC, Davis GA, Barnett P, Crichton A, Takagi M, Hearps SJC, Davies K, McKinlay A, Anderson N, Kwan V, Kanagalingam S, Ceregra G, Petris A, Darling S, Clifton P, Harcourt P. Child concussion recognition and recovery: a community delivered, evidenced-based solution. ANNALS OF TRANSLATIONAL MEDICINE 2020; 8:595. [PMID: 32566622 PMCID: PMC7290523 DOI: 10.21037/atm.2020.03.50] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Pediatric concussion is a growing health concern. Concussion is generally poorly understood within the community. Many parents are unaware of the signs and varying symptoms of concussion. Despite the existence of concussion management and return to play guidelines, few parents are aware of how to manage their child’s recovery and return to activities. Digital health technology can improve the way this information is communicated to the community. A multidisciplinary team of pediatric concussion researchers and clinicians translated evidence-based, gold-standard guidelines and tools into a smartphone application with recognition and recovery components. HeadCheck is a community facing digital health application developed in Australia (not associated with HeadCheck Health) for management of concussion in children aged 5–18 years. The application consists of (I) a sideline concussion check and (II) symptom monitoring and symptom-targeted psychoeducation to assist the parent manage their child’s safe return to school, exercise and sport. The application was tested with target end users as part of the development process. HeadCheck provides an accessible platform for disseminating best practice evidence. It provides feedback to help recognize a concussion and symptoms of more serious injuries and assists parents guide their child’s recovery.
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Affiliation(s)
- Cathriona Clarke
- Clinical Sciences Research, Murdoch Children's Research Institute, Melbourne, Australia
| | - Vicki Anderson
- Clinical Sciences Research, Murdoch Children's Research Institute, Melbourne, Australia.,Royal Children's Hospital, Melbourne, Australia.,Melbourne School of Psychological Sciences, University of Melbourne, Australia
| | - Franz E Babl
- Clinical Sciences Research, Murdoch Children's Research Institute, Melbourne, Australia.,Royal Children's Hospital, Melbourne, Australia.,Department of Paediatrics, University of Melbourne, Australia
| | - Vanessa C Rausa
- Clinical Sciences Research, Murdoch Children's Research Institute, Melbourne, Australia
| | - Gavin A Davis
- Clinical Sciences Research, Murdoch Children's Research Institute, Melbourne, Australia.,Department of Neurosurgery, Austin and Cabrini Hospitals, Melbourne, Australia
| | - Peter Barnett
- Clinical Sciences Research, Murdoch Children's Research Institute, Melbourne, Australia.,Royal Children's Hospital, Melbourne, Australia.,Department of Paediatrics, University of Melbourne, Australia
| | - Ali Crichton
- Clinical Sciences Research, Murdoch Children's Research Institute, Melbourne, Australia
| | - Michael Takagi
- Clinical Sciences Research, Murdoch Children's Research Institute, Melbourne, Australia.,Melbourne School of Psychological Sciences, University of Melbourne, Australia
| | - Stephen J C Hearps
- Clinical Sciences Research, Murdoch Children's Research Institute, Melbourne, Australia
| | - Katie Davies
- Clinical Sciences Research, Murdoch Children's Research Institute, Melbourne, Australia.,Neurological Rehabilitation Group, Melbourne, Australia
| | - Audrey McKinlay
- Clinical Sciences Research, Murdoch Children's Research Institute, Melbourne, Australia.,Department of Psychology, University of Canterbury, Ilam, New Zealand
| | - Nicholas Anderson
- Clinical Sciences Research, Murdoch Children's Research Institute, Melbourne, Australia
| | | | | | | | - Anita Petris
- Business Development, Murdoch Children's Research Institute, Melbourne, Australia
| | - Simone Darling
- Clinical Sciences Research, Murdoch Children's Research Institute, Melbourne, Australia.,Business Development, Murdoch Children's Research Institute, Melbourne, Australia
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Reyes J, Willmott C, McIntosh A, Howard TS, Clifton P, Makdissi M, Harcourt P, Cameron P, Rosenfeld JV, Nguyen JVK, Mitra B. The potential of head acceleration measurement to augment current best practice in concussion screening in professional Australian football players. Phys Ther Sport 2020; 43:210-216. [PMID: 32248080 DOI: 10.1016/j.ptsp.2020.03.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2020] [Revised: 03/23/2020] [Accepted: 03/23/2020] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To explore the potential utility of head acceleration event (HAE) measurements to augment identification of players for further concussion screening in non-helmeted contact sport. DESIGN Prospective observational pilot study. PARTICIPANTS 210 (118 female) professional Australian football players in 2017 season. METHODS Players wore the X-Patch® accelerometer for one match each with data collected across 14 matches. Players with HAEs above thresholds associated with concussion, 95 g (males) or 85.5 g (females), were compared to players identified to have suspected concussion by club personnel during the inspected matches. Video review of matches was undertaken by a physician blinded to HAEs to identify players with concussive signs. RESULTS Among 26 players (50% female) with HAEs above threshold, two players were screened for concussion. Of the remaining 24 players, nine were not visible on video at the HAE time, six sustained verifiable head impacts, and nine sustained verifiable body impacts with no head impacts. Among 184 players with HAEs below threshold, five players were screened. CONCLUSION Players were identified to have head impacts and suspected concussion in the absence of HAEs above threshold. Use of X-Patch® was not sufficiently reliable for identifying players for further concussion screening in professional Australian football. Video review of head impacts remains essential in concussion screening.
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Affiliation(s)
- Jonathan Reyes
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton Campus, Melbourne, Australia.
| | - Catherine Willmott
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton Campus, Melbourne, Australia; Monash-Epworth Rehabilitation Research Centre, Epworth Hospital, Melbourne, Australia.
| | - Andrew McIntosh
- School of Engineering and Australian Collaboration for Research into Injury in Sport and its Prevention, Edith Cowan University, Joondalup, Australia; Monash University Accident Research Centre, Monash University, Melbourne, Australia.
| | - Teresa S Howard
- National Trauma Research Institute, The Alfred Hospital, Melbourne, Australia; Department of Surgery, Monash University, Melbourne, Australia.
| | | | - Michael Makdissi
- Florey Institute of Neuroscience and Mental Health, Austin Campus, Melbourne Brain Centre, Heidelberg, Victoria, Australia; Olympic Park Sports Medicine Centre, Melbourne, Victoria, Australia.
| | | | - Peter Cameron
- National Trauma Research Institute, The Alfred Hospital, Melbourne, Australia; Emergency & Trauma Centre, The Alfred Hospital, Australia; Department of Epidemiology & Preventive Medicine, Monash University, Australia.
| | - Jeffrey V Rosenfeld
- Department of Surgery, Monash University, Melbourne, Australia; Department of Neurosurgery, The Alfred Hospital, Australia; Department of Surgery, F. Edward Hébert School of Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD, USA.
| | - Jack V K Nguyen
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton Campus, Melbourne, Australia.
| | - Biswadev Mitra
- National Trauma Research Institute, The Alfred Hospital, Melbourne, Australia; Emergency & Trauma Centre, The Alfred Hospital, Australia; Department of Epidemiology & Preventive Medicine, Monash University, Australia.
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Gunasekaran P, Hodge C, Pearce A, King D, Fraser C. A review of concussion diagnosis and management in Australian professional sporting codes. PHYSICIAN SPORTSMED 2020; 48:1-7. [PMID: 31132020 DOI: 10.1080/00913847.2019.1624656] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Objectives: The recognition and management of concussion has become a major health concern across all sports. Despite recent attention, concussion assessment and return-to-play protocols appear to be highly variable between leading professional sporting bodies across Australia. Without readily available guidelines, players at all levels may be at risk of suboptimal management following in-game trauma. The purpose of this study was to explore the publicly available concussion guidelines of the major Australian sporting codes with an aim to identify potential opportunities to develop a national sporting consensus.Methods: Internet sites of the major sporting organizations within Australia were accessed between June 2018 to July 2018. Sites were reviewed for information pertaining to an available concussion protocol or guidelines including; concussion definition, player education documentation, requirement of baseline testing, standard concussion diagnostic measures, use of sideline testing and removal from play guidelines, return-to-play, minimum return-to-play intervals and the implementation of external evaluation of potential concussion cases.Results: Twelve sites were visited. There was consensus between many of the sporting organizations in terms of concussion definition, removal of play and sideline testing protocols. A step-wise return-to-play protocol was prevalent across most sports. A number of sporting sites however did not have readily available information.Conclusions: There is notable room for the development of concussion guidelines in Australian sport. Researchers and sporting organizations need to continuously amend current protocols to ensure this reflects best evidence-based practice.
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Affiliation(s)
- Premkumar Gunasekaran
- Discipline of Orthoptics, Graduate School of Health, University of Technology Sydney, Sydney, Australia
| | - Christopher Hodge
- Discipline of Orthoptics, Graduate School of Health, University of Technology Sydney, Sydney, Australia.,The University of Sydney, Save Sight Institute, Discipline of Ophthalmology, Sydney Medical School, Sydney, Australia
| | - Alan Pearce
- School of Allied Health, La Trobe University, Melbourne, Australia
| | - Doug King
- School of Science and Technology, University of New England, Armidale, Australia
| | - Clare Fraser
- The University of Sydney, Save Sight Institute, Discipline of Ophthalmology, Sydney Medical School, Sydney, Australia
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Elkington LJ, Manzanero S, Hughes DC. An update to the AIS-AMA position statement on concussion in sport. Med J Aust 2019; 208:246-248. [PMID: 29614933 DOI: 10.5694/mja17.01180] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2017] [Accepted: 01/31/2018] [Indexed: 11/17/2022]
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