Many Kids With Concussions Do Not Receive Medical Follow-Ups

More than two-thirds of youth and children with an acute concussion do not seek medical follow-up or clearance.

It's important to know that after a concussion the brain is more sensitive to damage. Repeated concussions or a severe concussion may lead to long-lasting problems with movement, learning, or speaking.

In a study that looked at data over a 10-year period, York University researchers, in collaboration with Children's Hospital of Eastern Ontario (CHEO) and the Institute for Clinical Evaluative Sciences (ICES), found that more than two-thirds of youth and children with an acute concussion do not seek medical follow-up or clearance as recommended by current international concussion guidelines.

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‘It is unclear why the rate of follow-up visits after a pediatric concussion diagnosis remain unacceptably low.’

In one of the first studies in Canada to look at pediatric concussion and follow-up, Professor Alison Macpherson in the Faculty of Health, School of Kinesiology & Health Science at York University and former York University Ph.D. student Liraz Fridman, conducted research that included data from over 120,000 children aged 5-19 years of age. The goal of the study was to determine whether children and youth with concussion receive follow-up visits in accordance with the recommended guidelines.

The team looked at population-based administrative data housed at ICES from all concussion-related visits to emergency department and physician offices in Ontario from 2003-2013.

Researchers analyzed the percentage of children and youth seen for follow-up. Over the decade of study, the data showed that there was an increase in the number of children who sought follow-up care after being evaluated for a concussion by 2013 but over two-thirds still did not receive follow-up care in accordance with international recommended guidelines.

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"That two-thirds of children were still not being seen for follow-up was surprising considering that international recommendations have been in place since 2001," says Fridman.

In Ontario, concussion-related emergency department and office visits rates per 100,000 children have quadrupled from 2003 to 2013, with similar increases noted in the United States. Concussions can have long-term effects on memory and cognition, and may increase the vulnerability of psychological implications, such as depression and anxiety.

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In 2003, 11 per cent of children and youth were seen for a follow-up after sustaining a concussion and by 2013 that number jumped to 30 percent.

"A lack of sufficient follow-up care puts children and youth at risk for another concussion or more serious consequences," says Macpherson.

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Researchers say it is unclear why those who have concussions do not receive adequate follow-up and treatment. However the study highlights the need for better education programs for health care professionals, parents, coaches, children and youth which may improve follow-up rates.

"Despite improvement over the past several years, the rate of follow-up visits after a pediatric concussion diagnosis remain unacceptably low." says Dr. Roger Zemek, Director of Clinical Research at the Children's Hospital of Eastern Ontario and a senior author. "This reinforces the ongoing need to ensure that the latest concussion guidelines are implemented broadly in order to standardize the approach to concussion diagnosis and management."

Source-Eurekalert