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A National Review of Inpatient Admissions for Pediatric Concussion
Tara Rhine, MD, MS, Lynn Babcock, MD, MS, and Mekibib Altaye, PhD, Cincinnati Children's Hospital Medical Center, Cincinnati OH

Abstract: Purpose: While the vast majority of concussions are managed as an outpatient, a proportion will require inpatient admission for symptomatic management and observation. Methods: Retrospective analysis of children (400 beds) hospitals (<19 years old) hospitalized for traumatic brain injuries (TBI) from 2007 - 2013. Data were collected from 42 pediatric hospitals using the Pediatric Health Information System database. Trends over time were assessed using the Cochran-Armitage Trend Test. Results: There were 80465 children admitted with TBI, of which 16599 (20.6%) were classified as concussion. Over the 7 years, while total number of TBI admissions remained stable, concussion admissions increased significantly by 4.2%(p<0.0001). Children admitted for concussion were mostly male (66.6%), white (62.6%) and had a median age of 11 years old, these demographics did not change over time. Private and government insurances each accounted for about 40% of admissions, although the admission rate of self-pay children has significantly declined (p<0.0001). Mechanisms of injury included falls (32%), motor vehicle accidents (25%), sports (13%), struck by/against (9%), other transport (7%), and other (12%). The proportion of children admitted for falls or sports injuries significantly increased (p<0.001). Finally, we found that significantly more children are being admitted to large (>400 beds) hospitals (p<0.001). Conclusions: Despite a stable rate of inpatient hospitalizations for pediatric traumatic brain injury over the past 7 years, the proportion of children admitted for concussion has significantly increased. Further analyses evaluating the exact purpose and cost of these hospitalizations are warranted.

Objective: Describe national trends of pediatric hospitalizations for concussion from 2007-2013.

Objective Content: We will review seven years of national data, after which the learner will understand changes in trends for those children admitted with concussion. We hope this data stimulates discussion and future studies on identifying what has spurred these changes, as well as delineating the purpose for concussion admissions.

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