175076 Hospitalizations for sport-related concussions in US children aged 5 to 18 years during 2000-2004

Tuesday, October 28, 2008

Jingzhen Yang, PhD, MPH , Community and Behavioral Health, College of Public Health, University of Iowa, Iowa City, IA
George Phillips, MD, FAAP, CAQSM , The Department of Pediatrics, Roy J. & Lucille A. Carver College of Medicine, Iowa City, IA
Huiyun Xiang, MD, MPH, PhD , Center for Injury Research and Policy, The Research Institute at Nationwide Children's Hospital, Columbus, OH
Veerasathpurush Allareddy, DDS , Health Management and Policy, University of Iowa, Iowa City, IA
Erin O. Heiden, MPH , Department of Community and Behavioral Health, University of Iowa, Iowa City, IA
Corinne Peek-Asa, PhD, MPH , Occupational and Environmental Health, University of Iowa, Iowa City, IA
Objectives: To describe patient and hospital characteristics associated with hospitalization for a diagnosis of non-fatal sport-related concussion, and to determine factors associated with these hospitalizations.

Methods: Children aged 5 to 18 with a primary diagnosis of a sport-related concussion in the Nationwide Inpatient Sample (2000-2004) were identified. Length of stay and hospital charges for non-fatal sport-related concussions were described. Logistic regression was used to assess the relationships of patient or hospital characteristics and sport-related concussion hospitalizations.

Results: Between 2000 and 2004, a total of 755 non-fatal pediatric sport-related concussion hospitalizations were identified. Nationwide, this represents 3,712 hospitalizations and over $29 million total hospital charges, with nearly $6 million in total hospital charges per year. Over half (52.3%) of the concussion patients experienced loss of consciousness. Over 80% of the concussion hospitalizations received no procedures during their average 1.1 days (median=0.8 day) of hospital stay. Older age, but not gender, was associated with increased odds of sport-related concussion hospitalizations. Non-teaching hospitals or hospitals in rural areas had significantly greater odds of admitting sport-related concussions versus other sport-related traumatic brain injuries compared to teaching or urban hospitals, with odds ratio (OR)=1.91 (95%CI: 1.44, 2.53), and OR=1.75 (95% CI: 1.11. 2.77), respectively.

Conclusions: Management of pediatric sport-related concussions varied at the individual and hospital-level. Better guidelines are needed for the identification and management of sport-related concussions. Standardized procedures for hospitals treating concussive injuries may also be warranted.

Learning Objectives:
1) Recognize patient and hospital characteristics associated with sport-related concussion hospitalization among children aged 5 to 18. 2) Discuss the relationship between hospital characteristics and length of stay and total hospital charge in study population; and 3) Develop better guidelines for the identification and management of sport-related concussions.

Keywords: Children and Adolescents, Healthcare Costs

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: No conflict interest
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.