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Study highlights incidence of non-sports-related concussion in children
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Although most concussions in pediatric patients older than 6 years of age were sports related, investigators found about one-third of concussions were sustained through non-sport activities.
"While concussions in sports are common and receive a lot of attention, concussions don't just happen in sports, they happen in life,” study co-author Christina L. Master, MD, told Healio.com/Orthopedics. “This is especially true for younger children, and clinicians need to remember to consider concussion as a diagnosis when taking care of kids with injuries. Along those same lines, this data should inform opportunities for prevention — not just in sports, but in other areas of life.” She added, “Recovery from concussion is not just about return to play or return to sport, but return to life activities in general."
Master and colleagues identified 9,704 pediatric patients who visited the Children’s Hospital of Philadelphia network for a concussion between July 1, 2012 and June 30, 2014. For a manual record review, 1,625 children were randomly chosen from the cohort to assess injury mechanisms and activities.
Results showed 70% of concussions were sports-related, but this varied by age. Investigators noted 18% of concussions in children up to age 4 years were not sports-related. However, the rates of sports-related concussion were 67% in patients aged 5 to 11 years and 77% for patients aged 12 to 14 years. For patients aged 15 to 17 years, the rate was 73%. Primary mechanisms of injury in patients who sustained concussions not from sports were being struck by an object and falls. – by Monica Jaramillo
Disclosures: The researchers report no relevant financial disclosures.
Perspective
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Anthony P. Kontos, PhD
The current study examined reported mechanisms of concussion among pediatric patients aged 0 to 17 years from one hospital’s electronic health records. The researchers reported that although sport-related concussions (SRC) were the most common (70%) mechanism of injury, other mechanisms, including falls and being struck by an object, were reported, particularly among patients younger than 5 years. Regarding gender, males reported a higher proportion of SRCs than females. The researchers examined the role of race/ethnicity and socio-economic status and found the proportion of non-Hispanic black children and those with Medicaid insurance or who self-paid reporting SRCs was lower than other groups. This may be related to limited access to care or perceptions that SRCs are minor and do not need to be treated, such as with low-grade sprains/strains. Of note, only one-fourth of patients with SRC and only 10% of patients without SRC sought care the day of their injury. This finding suggests evaluation and treatment of these patients is delayed, which may potentially expose children to additional injury and prolonged recovery. Alternately, some patients may not experience symptoms/impairment until later, delaying their presentation. The study included a large sample, but researchers reported only proportional rates rather than incidence rates.
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