Better awareness of traumatic brain injury may be reason, experts say
MONDAY, Sept. 30, 2013 (HealthDay News) -- Many more children are showing up at emergency departments with traumatic brain injuries -- such as concussions -- from sports activities, a new study finds.
Doctors at the Cincinnati Children's Hospital Medical Center found that the number of emergency department visits for these injuries increased 92 percent between 2002 and 2011.
Meanwhile, although the number of children admitted to the hospital rose in proportion to emergency department visits, the hospitalization rate held at a steady 10 percent.
One bright spot in the study was that the severity of injuries decreased. And the rise in emergency department visits is probably due in part to better awareness, experts said.
"We are doing a better job at educating ourselves and educating the public about concussion," said Dr. Holly Hanson, lead study author and an emergency medicine fellow. "People and doctors are recognizing sports-related concussions more. People are recognizing the signs and symptoms. People are more aware of the complications. So people are coming in more."
Children today are bigger and faster, Hanson said, and the increased weight and velocity may also be causing more of these injuries. "That's my best guess," she said.
The activities that had the highest admission rates per patients seen in the ER for traumatic brain injury were skiing, sledding, inline skating and skateboarding, the investigators found. "These activities don't have a lot of regulation or trainers around. So being smart about helmets is important," Hanson said.
For the study, Hanson's team collected data on nearly 3,900 children seen in the emergency department for a sports-related traumatic brain injury. Of these, 372 were admitted to the hospital.
Although more children were seen over time, the severity of their injuries was reduced, which was most likely due to more parents being cautious and concerned, and bringing their children to the hospital to be examined, Hanson said.
Parents shouldn't take head injuries lightly, she added. "It could cause both short-term and long-term consequences if ignored," Hanson said. "Seeking care is most important."
The report was published online Sept. 30 and in the October print issue of Pediatrics.
Another expert thinks more awareness of concussions is increasing the numbers of children being seen in hospitals for them.
Dr. Ann Hyslop, a pediatric neurologist at Miami Children's Hospital, said that "more children are going to the emergency room for traumatic brain injuries across the country and that speaks to increased traumatic brain injury awareness and the need for concussion identification early."
Hyslop said she too has seen an increase in the number of children being seen in emergency rooms and in clinics, including those referred by pediatricians for concussion.
Many children will get better within a short time, but for others more care is needed, she said.
"About 95 percent of children are going to get better within a couple of weeks," Hyslop said. "But during that time they can have problems with concentration, sleep, headaches, behavioral and mood issues."
For children whose condition doesn't improve, other treatments -- such as physical therapy, speech therapy, help in concentrating and long-term sleep and headache management -- may be needed, Hyslop noted. "That's about 5 to 10 percent of children," she said.
Hyslop also pointed out that more children are wearing helmets and more parents are following car seat recommendations. "But we have a lot of room to improve," she added.
Traumatic brain injuries are responsible for some 630,000 emergency room visits, more than 67,000 hospitalizations, and 6,100 deaths in children and teens each year, according to previous research from the U.S. Centers for Disease Control and Prevention.
Across the United States, the number of children seen for sports-related traumatic brain injuries increased 62 percent between 2001 and 2009, other studies have found.
For more about concussions, visit the U.S. National Library of Medicine (http://www.nlm.nih.gov/medlineplus/concussion.html ).
SOURCES: Holly Hanson, M.D., emergency medicine fellow, Cincinnati Children's Hospital Medical Center; Ann Hyslop, M.D., pediatric neurologist, Miami Children's Hospital; October 2013, Pediatrics