Posted on Dec 12, 2017
Pediatric Concussion 'Grossly' Underdiagnosed in Hospital Emergency Departments
Written by Editor
Friday, November 17, 2017 07:34 AM
Concussions were "grossly" underdiagnosed among children presenting to a Level 1 trauma center's pediatric emergency department, according to a study. “We aren’t very good at diagnosing concussions in an emergency department setting,” the study author said.
The investigators, with the New Jersey Medical School's Department of Emergency Medicine in Newark, concluded that providers need to be better educated about recognizing traumatic brain injury (TBI).
More than 60% of the children who showed signs of concussion at University Hospital’s emergency department during two study periods were not diagnosed as having one. Suffering an injury while participating in sports and undergoing a CT scan predicted underdiagnosis; those involved in auto accidents, on the other hand, were more likely to be diagnosed with concussion.
This was a single-center study with 17,000 patients overall in 2015 in a dedicated pediatric emergency department at a level 1 trauma center. Eighty-seven of the 233 children who "had features compatible with the diagnosis of concussion" were diagnosed, giving an underdiagnosis rate of 62.7%. Data on this population were extracted from the 610 children who were evaluated for head injury at the center, tallied via querying a database for “head injury."
You would think a sports-related injury is the time you would think most about concussions, the author noted .” The first step to addressing sports concussion is removing injured athletes from action and getting them medical attention. That’s not happening often enough, “even in an emergency department, we know we’re not seeing everyone who has a concussion.”