@article{ref1,
title="Annual and seasonal trends in ambulatory visits for pediatric concussion in Ontario between 2003 and 2013",
journal="Journal of pediatrics",
year="2016",
author="Zemek, Roger L. and Grool, Anne M. and Rodriguez Duque, Daniel and DeMatteo, Carol and Rothman, Linda and Benchimol, Eric I. and Guttmann, Astrid and Macpherson, Alison K.",
volume="181",
number="",
pages="222-228.e2",
abstract="OBJECTIVE: To investigate annual and seasonal trends in physician office and emergency department (ED) visit rates for pediatric concussion in Ontario, Canada between 2003 and 2013. STUDY DESIGN: A retrospective, population-based study was conducted using linked health administrative data from all concussion-related visits to ED and physician office by children aged 5 through 18 years. Time series analysis was used to assess whether periodic components exist in the monthly number of concussion-related visits. <br><br>RESULTS: Over the 11-year study period, there were 176 685 pediatric visits for concussion in EDs and physician offices in Ontario. Standardized concussion-related visits showed a 4.4-fold (95% CI 4.37-4.45) increase per 100 000 from 2003 to 2013, with nearly 35 000 total visits in 2013. Concussion-related visits demonstrated a steep increase from 2010 onward. The greatest increases in standardized visits were in females (6.3-fold, 95% CI 6.23-6.46 vs 3.6-fold, 95% CI 3.56-3.64 in males) and 13-18.99 year olds (5.0-fold, 95% CI 4.93-5.08 vs 4.1-fold, 95% CI 3.99-4.27 in 9-12 years and 2.3-fold, 95% CI 2.23-2.42 in 5-8 years). A strong seasonal variability (R(2)autoreg = 0.87, P < .01) in the number of concussion-related visits was present, with most occurring in fall and winter. <br><br>CONCLUSIONS: Pediatric concussion-related ED and physician office visit rates have greatly increased in the last decade, particularly since 2010. Prevention strategies may be targeted at those most at risk and at seasonal-related activities carrying the greatest risk of concussion.<br><br>Copyright © 2016 Elsevier Inc. All rights reserved.<p /> <p>Language: en</p>",
language="en",
issn="0022-3476",
doi="10.1016/j.jpeds.2016.10.067",
url="http://dx.doi.org/10.1016/j.jpeds.2016.10.067"
}