Characteristics and Outcomes for Delayed Diagnosis of Concussion in Pediatric Patients Presenting...

Past research has found that concussed youth may be underdiagnosed in the emergency department (ED), but outcomes for those with delayed diagnosis have yet to be described. In a recent study led by PISC Senior Scholar, Daniel Corwin, MD, MSCE, and colleagues, they sought to compare visit characteristics and outcomes of patients who present to the ED with head injury who receive immediate vs. delayed diagnosis. Corwin et al. conducted retrospective chart review of patients aged 6 to 18 years diagnosed with concussion on their first ED or urgent care (UC) visit and patients requiring a second visit for diagnosis between July 1, 2017 and June 20, 2019.

Those with immediate diagnosis had more symptoms inquired at initial visit and a higher likelihood of receiving concussion-specific physical examination. Those with delayed diagnosis had more medical visits during recovery, longer average time to symptom resolution, and a higher likelihood of having persistent concussion symptoms. Concussed children evaluated acutely for head injury who do not receive an immediate diagnosis may be at risk for persistent symptoms. Performance of a concussion-specific physical examination and use of a standardized symptom scale may aid in identification of concussed youth acutely.

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