Characteristics of youth who leave the emergency department without being seen following sports-related concussion

Abstract

Aim: Despite the rising incidence of emergency department (ED) visits for sports-related concussion, the frequency and characteristics of youth leaving before being seen are unknown. Methodology: National estimates of ED visits for sports-related head injuries among youth (10–18 years) were generated for 2006–2017 using the National Electronic Injury Surveillance System. Logistic regression models estimated the odds of leaving without being seen across patient characteristics and time. Results: From 2006 to 2017, 985,966 (95% CI: 787,296–1,184,637) ED visits were identified for sports-related concussions, of which 5015 (95% CI: 3024–7006) left without being seen. Conclusion: Youth with sports-related concussion must receive timely care and ED improvements may reduce rates of leaving without being seen.

Sports-Related Concussion Is a Personalized Issue—Evaluation of Medical Assessment and Subjective Feeling of the Athlete in a German Level 1 Trauma Center

“…In the evaluation of the medical records, 13.1% of the athletes had indicated symptoms after completing the medical surveillance period, whilst in the questionnaire performed 6 months after an SRC, 41.0% still indicated remaining symptoms in the self-report. Symptoms of a concussion sometimes can be difficult to discover because of their diversity and late onset, up to 48 h after the impact [ 16 ], and therefore, are overlooked in clinical settings [ 13 , 17 , 18 , 19 ]. Directly after the accident, the most common reported symptoms were the loss of consciousness (41.2%) and headache (36.5%).…”

“…Rowe et al found that one out of six patients in emergency departments were misdiagnosed despite, having clear symptoms of concussion [ 19 ]. Other investigations postulated bad management and lack of guidelines in hospitals, as well as insufficient realization [ 13 , 18 , 42 ]. Recently discovered correlation between biomarkers and concussions could help to reduce the number of misdiagnosed cases [ 21 , 43 ].…”

Disparities and Inequities in Youth Sports

“…Lastly, there exist inequities with regard to delivery of care. A recent study of youth who sustained an SRC over the last decade found that racial minorities were more likely to leave the emergency department before being seen (59). Also, Hispanic youth, individuals with low English proficiency, and those with nonprivate insurance are less likely to receive subspecialty concussion care (60).…”

Race, ethnicity, and clinical outcome following sport-related concussion: a systematic review

“…Results from two emergency department (ED) surveillance datasets reporting on ED visits throughout the United States indicated that black youth were less likely to visit the emergency department for a head injury or concussion compared to non-Hispanic white youth (6,8). Further, among youth presenting to the ED for a sport-related concussion, nonwhite youth were more likely to leave without being seen by a healthcare provider (11). Disparities have also been reported in terms of specialty care access, such that Hispanic youth were less likely to be seen for subspeciality concussion care, compared to subspecialty care for fractures (7).…”