Assessment of acute head injury in an emergency department population using sport concussion assessment tool – 3rd edition

Zahid, Abdullah Bin; Hubbard, Molly E.; Dammavalam, Vikalpa; Balser, David; Pierre, Gritz; Kim, Amie; Kolecki, Radek; Mehmood, Talha; Wall, Stephen P.; Frangos, Spiros G.; Huang, Paul P.; Tupper, David E.; Barr, William; Samadani, Uzma

doi:10.1080/23279095.2016.1248765

Cited by 18 publications

(35 citation statements)

References 23 publications

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“…8,26 The observed shift in type of healthcare provider encountered, specifically the decrease in claims for care by ambulance and radiology providers, can be partly attributed to the increased treatment of mild injuries at ED and/or the reduced reliance on imaging, which is needed only if a more severe TBI is suspected. Previous studies have demonstrated the Sport Concussion Assessment Tool-3rd edition (SCAT3) and ChildSCAT3 for children ages 5-12 years had a high sensitivity in measuring the signs and symptoms of concussions in an ED setting, 27,28 reducing the need for diagnostic radiology. Moreover, the Pediatric Emergency Care Applied Research Network has advised against the use of imaging in children without severe signs and symptoms, further decreasing the number of healthcare encounters in radiology post-law.…”

Section: Discussionmentioning

confidence: 99%

Initial Emergency Department Visit and Follow-Up Care for Concussions among Children with Medicaid

Tarimala

Singichetti

et al. 2019

The Journal of Pediatrics

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Objective To describe the rates and patterns of initial emergency department (ED) encounters and follow-up care for concussions among Medicaid-insured children before and after the 2013 enactment of Ohio concussion law.Study design Using a time-series design, this study analyzed concussion claim data obtained from Partners for Kids, a pediatric accountable-care organization in Ohio. A total of 12 512 concussions and 48 238 associated claims for services between January 1, 2008, and June 30, 2017, with an initial ED encounter among Medicaid-insured children (ages 0-18 years) were analyzed. The effect of the law on the odds of follow-up care were assessed using generalized estimating equations models, adjusted for sex, age group, and residence location. ResultsOf the total 12 512 concussions, 63.9% occurred in male patients, 70.1% in patients ages 10-18 years, and 65.2% in patients from urban areas. The rate of initial ED encounters for concussions increased from 2008 to 2014 (2.8 to 4.9 per 10 000 members), followed by a decrease in 2016 (4.2 per 10 000 members). A significant increase in follow-up care after the initial ED encounter was observed from pre-law to post-law (OR 1.73, 95% CI 1.61, 1.86). A shift in follow-up care was observed from radiology and ambulance services in pre-law to primary care providers in post-law.Conclusions The Ohio concussion law may have influenced the patterns of initial ED visit and follow-up care for concussions among Medicaid-insured children. Future studies evaluating the impact of the law should analyze the utilization patterns among children with various insurance/payment types. (J Pediatr 2019;206:178-83).

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Section: Discussionmentioning

confidence: 99%

Initial Emergency Department Visit and Follow-Up Care for Concussions among Children with Medicaid

Tarimala

Singichetti

et al. 2019

The Journal of Pediatrics

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“… 7 , 9 – 17 The CSSS has also been used to monitor recovery after injury 7 , 9 , 18 and in non-sport-related TBI patients with injuries severe enough to require computed tomography (CT) imaging. 19 …”

Section: Introductionmentioning

confidence: 99%

Using sideline concussion tests in the emergency department

Kruse

Nugent

Peterson

2018

OAEM

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PurposeTraumatic brain injury (TBI) is a significant cause of death and disability in the United States. Many patients with TBI are initially treated in the emergency department (ED), but there is no evidence-based method of detecting or grading TBI in patients who have normal structural neuroimaging. This study aims to evaluate the validity of two common sideline concussion tests. The Concussion Symptom Severity Score (CSSS) and modified Balance Error Scoring System (mBESS) tests are well-validated sideline tests for concussion, but have not been validated in the setting of non-sport-related concussion, in settings other than the sideline or athletic training room or in moderate or severe TBI.Patients and methodsOne hundred forty-eight subjects who had sustained a TBI within the previous 72 hours and 53 healthy control subjects were enrolled. CSSS and mBESS were administered. Clinical outcomes were followed up prospectively.ResultsThe CSSS was collected in 147 TBI subjects but only 51 TBI subjects were able to complete the mBESS. The CSSS was collected for all 53 control subjects, and the mBESS was completed for 51 control subjects. The mean CSSS for TBI and control subjects was 32.25 and 2.70, respectively (P < 0.001). The average mBESS for TBI and control subjects was 7.43 and 7.20, respectively (P = 0.82). CSSS greater than 5.17 was 93.43% sensitive and 69.84% specific for TBI.ConclusionThe mBESS is poorly tolerated and, among those who can complete the test, not sensitive to TBI in the ED. The CSSS is both sensitive to TBI and well tolerated.

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“…The average number of SCAT3 symptoms endorsed has been estimated between 1.75 and 3.2 for the general population. [15][16][17] By comparison, the number of these symptoms endorsed by youth athletes who sustained HIs was 9.7. 16 Consistent with these studies, our data revealed a higher number of postconcussive symptoms endorsed by cyclists who reported HIs versus those who did not.…”

Section: Discussionmentioning

confidence: 95%

Reporting of Concussion-Like Symptoms After Cycling Crashes: A Survey of Competitive and Recreational Cyclists

Rice

Iaccarino

Bhatnagar

et al. 2020

Journal of Athletic Training

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Context Cycling crashes are common among recreational and competitive riders and may result in head and bodily trauma. Information is limited regarding the signs and symptoms of head injury (HI) after cycling crashes, medical treatment, and recovery. Objectives To evaluate concussion-like symptom reporting after cycling crashes with or without HI in recreational and competitive cyclists and to assess crash characteristics and follow-up medical care. Design Cross-sectional study. Setting Voluntary online survey. Patients or Other Participants A convenience sample of 780 cyclists residing in the United States: 528 males, 249 females, 2 gender queer/nonbinary, and 1 transgender female. Main Outcome Measure(s) Survey-based, self-reported signs and symptoms of HI, including the third edition of the Sport Concussion Assessment Tool (SCAT3) symptom checklist, loss of consciousness, posttraumatic amnesia, and helmet damage. Results Of the participants, 403 reported crashes in the previous 2 years. Cyclists who self-reported no significant injury after their crash were excluded, leaving 77 HI reporters (HI group) and 260 trauma controls (TC group). The HI group more frequently reported experiencing 17 of the 22 symptoms on the SCAT3 symptom checklist. The HI group described a 4-fold higher incidence of loss of consciousness (HI = 13/77 [16.9%] versus TC = 11/2600 [4.2%]) and memory loss immediately after the crash (HI = 44/77 [57.1%] versus TC = 37/260 [14.2%]). The HI group reported major, noncosmetic helmet damage 2.5 times more frequently than the TC group (HI = 49/77 [63.6%] versus TC = 67/260 [25.8%]). Conclusions The findings suggest that a standardized concussion assessment is needed for cyclists who experience major trauma.

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Assessment of acute head injury in an emergency department population using sport concussion assessment tool – 3rd edition

Cited by 18 publications

References 23 publications

Initial Emergency Department Visit and Follow-Up Care for Concussions among Children with Medicaid

Initial Emergency Department Visit and Follow-Up Care for Concussions among Children with Medicaid

Using sideline concussion tests in the emergency department

Reporting of Concussion-Like Symptoms After Cycling Crashes: A Survey of Competitive and Recreational Cyclists

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