Citation

Wallace JS, Mannix RC. J. Pediatr. 2021; ePub(ePub): ePub.

Copyright

(Copyright © 2021, Elsevier Publishing)

DOI

10.1016/j.jpeds.2021.01.057

PMID

unavailable

Abstract

OBJECTIVE: To determine if racial/ethnic differences exist in the diagnosis and mechanism of injury among children and adolescents visiting the emergency department (ED) for concussion and minor head trauma (MHT). STUDY DESIGN: A retrospective, cross-sectional study of patient (age≤19) visits to the ED for concussion between 2010-2015, using the National Hospital Ambulatory Medical Care Survey, was completed. The primary study exposure was race/ethnicity. Outcome measures included ED visits that resulted in a concussion/MHT diagnosis and mechanism of injury. Mechanism categories included sport, motor vehicle collision, fall, assault, and other mechanism. A multivariable logistic regression and multinomial logistic regression were conducted to assess relationships between race/ethnicity and outcomes.

FINDINGS were weighted to reflect population estimates.

RESULTS: In total, 1263 child/adolescent visits for concussion/MHT were identified, representing an estimated 6.6 million child/adolescent visits nationwide. Compared with non-Hispanic white pediatric patients, non-Hispanic black patients were least likely to have an ED visit for a concussion/MHT (P <.001, OR=0.66, 95% CI 0.52-0.83) The odds of non-Hispanic black children/adolescents (OR=3.80, 95% CI 1.68-8.55) and children/adolescents of other race/ethnicity (OR=4.93, 95% CI 1.09-22.23) sustaining a concussion/MHT resulting from assault versus sport was higher.

CONCLUSIONS: Amid the emerging focus on sport-related concussion, these ethnic/racial differences in ED diagnosis of concussion/MHT demonstrate sociodemographic differences that warrant further attention. Assault may be a more common mechanism of concussion among children/adolescents of a racial minority.

Language: en

Keywords

emergency department; concussion; assault; sport; racial disparities