Multi-disciplinary management of paediatricpediatric sports-related concussion: early experience of the pan am concussion program

Abstract

ObjectiveSummarise clinical characteristics, outcomes, and healthcare resources and personnel needs of paediatric sports-related concussion (SRC) patients who were evaluated and managed at a multi-disciplinary paediatric concussion program.DesignRetrospective cohort studySettingPaediatric, multi-disciplinary concussion clinicParticipants423 paediatric SRC patients: 14.3 years (SD: 2.3), 59.6% males, 43.0% hockey-related, and 75.8% acute SRCInterventions (or assessment of risk factors)Initial assessment and diagnosis by a neurosurgeon with the multi-disciplinary team completing Return-to-Play decision-making. On-site neurosurgeon, neuropsychologist, vestibulo-ocular therapist, and exercise physiologist and referrals to neurology and psychiatryOutcome measuresSRC diagnosis and recovery were defined by the 2013 Zurich Consensus Guidelines. Post-Concussion Syndrome was diagnosed using ICD-10 criteria of at least 3 symptoms at 30 days or more. Outcomes included demographic and injury data, healthcare resources and personnel utilised, and recoveryMain resultsOverall, 294 (69.5%) of SRC patients met the clinical criteria for recovery, 75 (17.7%) were lost to follow-up, 53 (12.5%) remained in treatment, and 1 died (0.2%). In acute patients, median time to initial consultation was 7 days (IQR: 5, 12). Median days to recovery among acute SRC patients with complete follow-up was 23 days (IQR: 15, 36) and 44.1% of acute SRC patients were diagnosed with PCS. 25.3% of SRC patients underwent at least one diagnostic imaging test and 32.6% received referral to another member of our multi-disciplinary clinical team.ConclusionsYouth received comprehensive care with access to appropriate diagnostic resources and multi-disciplinary collaboration of experts with national and provincially-recognised training in TBICompeting interestsNone.