From the Journals

Follow-up care for pediatric concussions not heeded in Ontario



Despite the rise in pediatric concussions, two-thirds of these youth do not return for recommended follow-up care in Ontario, reported Liraz Fridman, PhD, of York University, Toronto, and associates.

In a 10-year, retrospective, population-based study, 126,654 children aged 5-18 years presented with concussions to emergency departments and physician offices in Ontario between April 1, 2003, and March 31, 2014. In 2003, 7,126 children were evaluated for a concussion, compared with 21,681 children by 2013.

Soccer head injury James Boulette/iStockphoto
Overall, 36% of children returned for their concussion follow-up. In 2003, 11% of 7,126 concussion patients had a follow-up visit, increasing to 30% of 21,681 concussion patients who returned for follow-up in 2013. The median time to first follow-up was 8 days, Dr. Fridman and his associates reported.

Limitations to this study include that children treated by athletic therapists or chiropractors would have been missed, and that these data may not generalize across Canada or the United States, they said.

“In Ontario, the rate of follow-up care for concussions nearly tripled in both emergency departments and physician’s offices. Despite this significant improvement over time, more than two-thirds of all child and youth concussion patients still do not receive the minimum standard of care, according to accepted guidelines,” the researchers wrote, adding that the study’s findings suggest that better instructions for health care providers on management of concussion are needed.

SOURCE: Fridman L et al. J Pediatr. 2018;192:184-8

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