Concussion Treatment in Youth Seen in an Emergency Department Setting

Concussion in youth sport is a major public health concern. Approximately 144,000 youth patients are treated for a concussion in an emergency department each year in the United States. Youths’ developing brains may be more vulnerable to concussion-associated sequelae such as school absenteeism, reading disturbances, or neurobehavioral deficits. Little is known about concussion treatment disparities for youth patients seen in an ED setting. A retrospective ED chart review was performed at Thomas Jefferson University Hospital. The study period was from 2011 to 2015 and the sample population included youths between 4 and 21 years old presenting to the ED with a concussion. Predictor variables included estimated median household income, age, gender, race/ethnicity, insurance status, concussion mechanism, headgear status, number of symptoms, prior concussions, and mode of arrival to the ED. Outcome variables included discharge to a specialist or primary care provider, imaging, and prescription of medications. These variables were analyzed using a univariate logistic model. No significant relationship was found between estimated income, mode of arrival, race/ethnicity and outcome variables. Older youths were more likely to receive a CT scan than younger youths (OR 1.22,