Characteristics of Diagnosed Concussions in Children 0-4 Years of Age Presenting to a Large Pediatric Healthcare Network
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Characteristics of Diagnosed Concussions in Children 0-4 Years of Age Presenting to a Large Pediatric Healthcare Network

  • Published Date:

    June 16 2020

  • Source:
    Pediatr Emerg Care.
  • Language:

Public Access Version Available on: December 16, 2021, 12:00 AM information icon
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  • Alternative Title:
    Pediatr Emerg Care
  • Description:
    Objective: To comprehensively describe the natural history of concussion in early childhood between 0 and 4 years. Methods: Retrospective cohort study of 329 patients ages 0-4 years, with an ICD-9-CM concussion diagnosis in the Children’s Hospital of Philadelphia (CHOP) healthcare network from October 1, 2013 to September 30, 2015. Clinical data was abstracted from the CHOP electronic health record (EHR) which captured all clinical care visits and injury characteristics. Results: Nearly 9 out of 10 of patients (86.6%) sought care in the emergency department or urgent care setting, most commonly on the day of injury (56.2%) and as a result of a fall (64.4%). Over two thirds (64.4%) of patients or their parent/caregiver reported somatic symptoms (i.e. vomiting or headache) while close to half (49.2%) reported sleep issues. One in five identified emotional symptoms (21.9%) or visio-vestibular dysfunction (20.4%). Many patients also experienced symptoms not included in standard assessment tools including personality changes (34.0%) and change in appetite (12.8%). Conclusions: These results provide insight into the clinical characteristics of concussion in early childhood up to 4 years of age. Since assessment in this group relies heavily on parent/caregiver symptom reporting, rather than patient self-report, these results will aid clinicians with the challenge of diagnosing concussions in this population. These findings highlight the need to develop additional tools to adequately and systematically assess common signs and symptoms of concussion in early childhood that may not be included in standard assessment scales routinely used in older adolescents and adults.
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