Annual and Seasonal Trends in Ambulatory Visits for Pediatric Concussion in Ontario between 2003 and 2013

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• 作者：Roger L. Zemek ; MD¹ ; ² ; ^{rzemek@cheo.on.ca} ; Anne M. Grool ; MD ; PhD² ; Daniel Rodriguez Duque ; MMath³ ; Carol DeMatteo ; P&OT ; DIP ; MSc⁴ ; Linda Rothman ; PhD⁵ ; Eric I. Benchimol ; MD ; PhD ; FRCPC² ; ³ ; ⁶ ; Astrid Guttmann ; MDCM ; MSc ; FRCPC³ ; ⁷ ; Alison K. Macpherson ; PhD³ ; ⁵
• 关键词：concussion ; mild traumatic brain injury ; epidemiology ; children ; adolescents ; emergency ; primary care
• 刊名：The Journal of Pediatrics
• 出版年：2017
• 出版时间：February 2017
• 年：2017
• 卷：181
• 期：Complete
• 页码：222-228.e2
• 全文大小：1871 K
• 卷排序：181

文摘

To investigate annual and seasonal trends in physician office and emergency department (ED) visit rates for pediatric concussion in Ontario between 2003 and 2013.Study designA retrospective, population-based study was conducted using linked health administrative data from all concussion-related visits to ED and physician office by children aged 5 through 18 years. Time series analysis was used to assess whether periodic components exist in the monthly number of concussion-related visits.ResultsOver the 11-year study period, there were 176 685 pediatric visits for concussion in EDs and physician offices in Ontario. Standardized concussion-related visits showed a 4.4-fold (95% CI 4.37-4.45) increase per 100 000 from 2003 to 2013, with nearly 35 000 total visits in 2013. Concussion-related visits demonstrated a steep increase from 2010 onward. The greatest increases in standardized visits were in females (6.3-fold, 95% CI 6.23-6.46 vs 3.6-fold, 95% CI 3.56-3.64 in males) and 13-18.99 year olds (5.0-fold, 95% CI 4.93-5.08 vs 4.1-fold, 95% CI 3.99-4.27 in 9-12 years and 2.3-fold, 95% CI 2.23-2.42 in 5-8 years). A strong seasonal variability (R2autoreg = 0.87, P < .01) in the number of concussion-related visits was present, with most occurring in fall and winter.ConclusionsPediatric concussion-related ED and physician office visit rates have greatly increased in the last decade, particularly since 2010. Prevention strategies may be targeted at those most at risk and at seasonal-related activities carrying the greatest risk of concussion.