• Brain injury : [BI] · Sep 2015

    Outpatient follow-up and return to school after emergency department evaluation among children with persistent post-concussion symptoms.

    • Joseph A Grubenhoff, Sara J Deakyne, R Dawn Comstock, Michael W Kirkwood, and Lalit Bajaj.
    • a Department of Pediatrics, University of Colorado , Boulder , CO , USA.
    • Brain Inj. 2015 Sep 1; 29 (10): 1186-1191.

    ObjectiveTo describe differences in outpatient follow-up and academic accommodations received by children with and without persistent post-concussion symptoms (PPCS) after emergency department (ED) evaluation. It was hypothesized that children with PPCS would have more outpatient visits and receive academic accommodations more often than children without PPCS and that follow-up would be positively associated with receiving accommodations.MethodsChildren aged 8-18 years with acute (≤6hours) concussion at time of presentation to a paediatric ED were enrolled in an observational study. Outcomes were assessed through a telephone survey 30 days after injury.ResultsOf 234 enrolled participants, 179 (76%) completed follow-up. PPCS occurred in 21%. Only 45% of subjects had follow-up visits after ED discharge. Follow-up visit rates were similar for those with and without PPCS (58% vs. 41%, respectively; p = 0.07). Children with PPCS missed twice as many school days as those without (3 vs. 1.5; p < 0.001), but did not differ in receiving academic accommodations (36% vs. 53%; p = 0.082). Outpatient follow-up was associated with receiving academic accommodations (RR = 2.2; 95% CI = 1.4-3.5).ConclusionsOutpatient follow-up is not routine for concussed children. Despite missing more school days, children with PPCS do not receive academic accommodations more often. Outpatient follow-up may facilitate academic accommodations.

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