Trends in Pediatric Emergency Department Utilization for Mild Traumatic Brain Injury Before and After Legislation

J Head Trauma Rehabil. 2018 Nov/Dec;33(6):E30-E37. doi: 10.1097/HTR.0000000000000397.

Abstract

Objective: To examine the effect of state youth traumatic brain injury (TBI) legislation on pediatric emergency department (ED) utilization for sports and recreation-related mild TBIs (mTBIs).

Participants: ED visits by children ages 5 to 18 years between 2006 and 2014 in the Pediatric Health Information System database (N = 452 900).

Design: Retrospective analysis.

Main measures: Rates of ED visits, and injury comparison groups (mTBI, moderate to severe TBI, minor head injury, and long bone fracture).

Results: Of the 452 900 ED visits, 123 192 (27.2%) were for mTBI, along with visits for moderate to severe TBIs (n = 5190), minor head injuries (n = 54 566), and long bone fractures (n = 269 952). ED visits for mTBIs were more common among males (67.5%), children ages 10-14 years (42.1%), and the privately insured (50.6%). The proportion of mTBI ED visits increased significantly, particularly from 5 years prelegislation to immediately postlegislation (57.8 to 94.8 mTBI visits per 10 000 ED visits). A similar trend was observed for minor head injuries; however, no significant changes were observed for moderate to severe TBIs and long bone fractures.

Conclusion: Pediatric ED utilization trends for the injury comparison groups differed from each other, and from pre- and post-TBI legislation. Further research assessing effects of TBI legislation on healthcare utilization is warranted.

MeSH terms

  • Adolescent
  • Athletic Injuries / epidemiology*
  • Brain Injuries, Traumatic / epidemiology*
  • Child
  • Child, Preschool
  • Databases, Factual
  • Emergency Service, Hospital / statistics & numerical data*
  • Female
  • Fractures, Bone / epidemiology
  • Humans
  • Injury Severity Score
  • Male
  • Retrospective Studies
  • Return to Sport / legislation & jurisprudence*
  • Sports Medicine / legislation & jurisprudence*
  • United States / epidemiology