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. 2015 Sep;29(10):1186-1191.
doi: 10.3109/02699052.2015.1035325. Epub 2015 May 25.

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

Joseph A Grubenhoff  1   2 , Sara J Deakyne  3 , R Dawn Comstock  1   4 , Michael W Kirkwood  5   6 , Lalit Bajaj  1   2
Affiliations

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

Joseph A Grubenhoff et al. Brain Inj. 2015 Sep.

Abstract

Objective: To 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.

Methods: Children 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.

Results: Of 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).

Conclusions: Outpatient 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.

Keywords: Acute brain injury; brain concussion; emergency medicine; post-concussion symptoms; post-concussion syndrome; traumatic brain injury.

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Conflict of interest statement

Conflict of Interest Statement: The authors have no conflicts of interest to disclose.

References

    1. Bijur PE, Haslum M, Golding J. Cognitive and behavioral sequelae of mild head injury in children. Pediatrics. 1990;86(3):337–44. - PubMed
    1. Fay GC, Jaffe KM, Polissar NL, Liao S, Martin KM, Shurtleff HA, Rivara JM, Winn HR. Mild pediatric traumatic brain injury: a cohort study. Arch Phys Med Rehabil. 1993;74(9):895–901. - PubMed
    1. Maillard-Wermelinger A, Yeates KO, Gerry Taylor H, Rusin J, Bangert B, Dietrich A, Nuss K, Wright M. Mild traumatic brain injury and executive functions in school-aged children. Dev Neurorehabil. 2009;12(5):330–41. - PMC - PubMed
    1. Babikian T, Satz P, Zaucha K, Light R, Lewis RS, Asarnow RF. The UCLA longitudinal study of neurocognitive outcomes following mild pediatric traumatic brain injury. J Int Neuropsychol Soc. 2011;17(5):886–95. - PMC - PubMed
    1. Belanger HG, Vanderploeg RD. The neuropsychological impact of sports-related concussion: a meta-analysis. J Int Neuropsychol Soc. 2005;11(4):345–57. - PubMed