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Emergency-Room Visits for Youth-Sports Concussions Rapidly Rising

A children's hospital in Cincinnati experienced a 92 percent increase in the number of emergency-room visits for sports-related traumatic brain injuries (TBIs) between 2002 and 2011, according to a study published online Monday in the journal Pediatrics.

Physicians from Cincinnati Children's Hospital Medical Center retrospectively examined data from nearly 3,900 children and teenagers who came to the emergency room with TBIs (such as concussions) over the past decade. They set out to determine whether the percentage of youth-athletes seen in emergency departments and those admitted had increased, decreased, or leveled off during that timeframe.

Of those youth athletes, 372 were admitted (9.6 percent), according to the study. Between 2002 and 2011, the hospital saw an 85 percent increase in the percentage of athletes admitted to the hospital for sports-related TBIs.

But despite a large increase in the number of emergency-department visits and hospital admissions for sports-related TBIs, there was no significant change in the percentage of children admitted. That figure hovered around 10 percent for the entire 10-year span of the study.

For youth-athletes seen in the emergency room and discharged, football (29.1 percent), soccer (16.5 percent), and basketball (15.4 percent) were the most common sports responsible for TBIs. For admitted patients, the most common sports seen were football (24.1 percent), skateboarding/roller blading (16.1 percent), and baseball/softball (12.9 percent).

The average severity of concussions seen decreased significantly over the span of the study, indicating that more patients were being admitted to the hospital with milder injuries.

Additionally, the Cincinnati Children's physicians noted a large spike in the volume of sports-related TBIs beginning in 2009, although it's not entirely clear why this happened. They speculate that an increase in recognition of sports-related TBIs, more coaches educating athletes and parents about concussions, or more media attention could be at least partially responsible.

"More people are seeking care for TBI in the emergency department, and proportionately more are being admitted for observation," said Dr. Holly Hanson, an emergency medicine fellow at Cincinnati Children's and lead author of the study, in a statement. "Here in Cincinnati, we anticipate more children will be seeing their primary care physician or going to the Cincinnati Children's TBI clinic, due to the passage of recent Ohio legislation mandating medical clearance to return to play."

Ohio enacted youth-concussion legislation at the end of 2012, although it just became effective in March of this year. The new law had no impact on this study, therefore.

The findings from Cincinnati Children's meshes with previous studies on the rate of emergency-department visits for youth-sports concussions. A study presented in 2012 at the Pediatric Academic Societies' annual meeting found that the number of youth-athlete concussions diagnosed in emergency rooms had more than doubled over the past 10 years. Earlier this year, a report from the youth-sports-safety organization Safe Kids Worldwide found that more than 1.35 million children ages 19 and young went to emergency rooms with sports-related injuries in 2012, including nearly 164,000 children with sports-related concussions.

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