Hoffer, M E; Szczupak, M; Kiderman, A; Crawford, J; Murphy, S; Marshall, K; Pelusso, C; Balaban, C
Neurosensory Symptom Complexes after Acute Mild Traumatic Brain Injury Journal Article
In: PLoS ONE, vol. 11, no. 1, pp. e0146039, 2016.
Abstract | BibTeX | Tags: *Brain Injuries/co [Complications], *Vestibular Function Tests, acute disease, Adolescent, adult, Affective Symptoms/et [Etiology], Brain Injuries/di [Diagnosis], Cluster Analysis, Dizziness/et [Etiology], Emergency Service, Fatigue/et [Etiology], Female, Gait Disorders, Headache/et [Etiology], Hospital, Hospitals, Humans, Male, middle aged, Mild Cognitive Impairment/et [Etiology], Military, Nausea/et [Etiology], Neurologic/et [Etiology], Neuropsychological Tests, Principal Component Analysis, Prognosis, Sex Factors, Surveys and Questionnaires, symptom assessment, Trauma Severity Indices, university, Young Adult
@article{Hoffer2016,
title = {Neurosensory Symptom Complexes after Acute Mild Traumatic Brain Injury},
author = {Hoffer, M E and Szczupak, M and Kiderman, A and Crawford, J and Murphy, S and Marshall, K and Pelusso, C and Balaban, C},
year = {2016},
date = {2016-01-01},
journal = {PLoS ONE},
volume = {11},
number = {1},
pages = {e0146039},
abstract = {Mild Traumatic Brain Injury (mTBI) is a prominent public health issue. To date, subjective symptom complaints primarily dictate diagnostic and treatment approaches. As such, the description and qualification of these symptoms in the mTBI patient population is of great value. This manuscript describes the symptoms of mTBI patients as compared to controls in a larger study designed to examine the use of vestibular testing to diagnose mTBI. Five symptom clusters were identified: Post-Traumatic Headache/Migraine, Nausea, Emotional/Affective, Fatigue/Malaise, and Dizziness/Mild Cognitive Impairment. Our analysis indicates that individuals with mTBI have headache, dizziness, and cognitive dysfunction far out of proportion to those without mTBI. In addition, sleep disorders and emotional issues were significantly more common amongst mTBI patients than non-injured individuals. A simple set of questions inquiring about dizziness, headache, and cognitive issues may provide diagnostic accuracy. The consideration of other symptoms may be critical for providing prognostic value and treatment for best short-term outcomes or prevention of long-term complications.},
keywords = {*Brain Injuries/co [Complications], *Vestibular Function Tests, acute disease, Adolescent, adult, Affective Symptoms/et [Etiology], Brain Injuries/di [Diagnosis], Cluster Analysis, Dizziness/et [Etiology], Emergency Service, Fatigue/et [Etiology], Female, Gait Disorders, Headache/et [Etiology], Hospital, Hospitals, Humans, Male, middle aged, Mild Cognitive Impairment/et [Etiology], Military, Nausea/et [Etiology], Neurologic/et [Etiology], Neuropsychological Tests, Principal Component Analysis, Prognosis, Sex Factors, Surveys and Questionnaires, symptom assessment, Trauma Severity Indices, university, Young Adult},
pubstate = {published},
tppubtype = {article}
}
Zemek, R; Barrowman, N; Freedman, S B; Gravel, J; Gagnon, I; McGahern, C; Aglipay, M; Sangha, G; Boutis, K; Beer, D; Craig, W; Burns, E; Farion, K J; Mikrogianakis, A; Barlow, K; Dubrovsky, A S; Meeuwisse, W; Gioia, G; Meehan 3rd, W P; Beauchamp, M H; Kamil, Y; Grool, A M; Hoshizaki, B; Anderson, P; Brooks, B L; Yeates, K O; Vassilyadi, M; Klassen, T; Keightley, M; Richer, L; DeMatteo, C; Osmond, M H; Pediatric Emergency Research Canada Concussion, Team
Clinical Risk Score for Persistent Postconcussion Symptoms Among Children With Acute Concussion in the ED Journal Article
In: JAMA, vol. 315, no. 10, pp. 1014–1025, 2016.
Abstract | BibTeX | Tags: *Post-Concussion Syndrome/di [Diagnosis], Accidents, Adolescent, Age Factors, Area Under Curve, Athletic Injuries/co [Complications], Brain Concussion/di [Diagnosis], Brain Concussion/et [Etiology], Child, Emergency Service, Female, Follow-Up Studies, Hospital, Humans, Male, MEDICAL history taking, MULTIVARIATE analysis, Observer Variation, Outcome Assessment (Health Care), Post-Concussion Syndrome/et [Etiology], Preschool, Prospective Studies, RISK assessment, Sensitivity and Specificity, Sex Factors, Time Factors, Traffic/sn [Statistics & Numerical Data
@article{Zemek2016,
title = {Clinical Risk Score for Persistent Postconcussion Symptoms Among Children With Acute Concussion in the ED},
author = {Zemek, R and Barrowman, N and Freedman, S B and Gravel, J and Gagnon, I and McGahern, C and Aglipay, M and Sangha, G and Boutis, K and Beer, D and Craig, W and Burns, E and Farion, K J and Mikrogianakis, A and Barlow, K and Dubrovsky, A S and Meeuwisse, W and Gioia, G and {Meehan 3rd}, W P and Beauchamp, M H and Kamil, Y and Grool, A M and Hoshizaki, B and Anderson, P and Brooks, B L and Yeates, K O and Vassilyadi, M and Klassen, T and Keightley, M and Richer, L and DeMatteo, C and Osmond, M H and {Pediatric Emergency Research Canada Concussion}, Team},
year = {2016},
date = {2016-01-01},
journal = {JAMA},
volume = {315},
number = {10},
pages = {1014--1025},
abstract = {IMPORTANCE: Approximately one-third of children experiencing acute concussion experience ongoing somatic, cognitive, and psychological or behavioral symptoms, referred to as persistent postconcussion symptoms (PPCS). However, validated and pragmatic tools enabling clinicians to identify patients at risk for PPCS do not exist. OBJECTIVE: To derive and validate a clinical risk score for PPCS among children presenting to the emergency department. DESIGN, SETTING, AND PARTICIPANTS: Prospective, multicenter cohort study (Predicting and Preventing Postconcussive Problems in Pediatrics [5P]) enrolled young patients (aged 5-\<18 years) who presented within 48 hours of an acute head injury at 1 of 9 pediatric emergency departments within the Pediatric Emergency Research Canada (PERC) network from August 2013 through September 2014 (derivation cohort) and from October 2014 through June 2015 (validation cohort). Participants completed follow-up 28 days after the injury. EXPOSURES: All eligible patients had concussions consistent with the Zurich consensus diagnostic criteria. MAIN OUTCOMES AND MEASURES: The primary outcome was PPCS risk score at 28 days, which was defined as 3 or more new or worsening symptoms using the patient-reported Postconcussion Symptom Inventory compared with recalled state of being prior to the injury. RESULTS: In total, 3063 patients (median age, 12.0 years [interquartile range, 9.2-14.6 years]; 1205 [39.3%] girls) were enrolled (n=2006 in the derivation cohort; n=1057 in the validation cohort) and 2584 of whom (n=1701 [85%] in the derivation cohort; n=883 [84%] in the validation cohort) completed follow-up at 28 days after the injury. Persistent postconcussion symptoms were present in 801 patients (31.0%) (n=510 [30.0%] in the derivation cohort and n=291 [33.0%] in the validation cohort). The 12-point PPCS risk score model for the derivation cohort included the variables of female sex, age of 13 years or older, physician-diagnosed migraine history, prior concussion with symptoms lasting longer than 1 week, headache, sensitivity to noise, fatigue, answering questions slowly, and 4 or more errors on the Balance Error Scoring System tandem stance. The area under the curve was 0.71 (95% CI, 0.69-0.74) for the derivation cohort and 0.68 (95% CI, 0.65-0.72) for the validation cohort. CONCLUSIONS AND RELEVANCE: A clinical risk score developed among children presenting to the emergency department with concussion and head injury within the previous 48 hours had modest discrimination to stratify PPCS risk at 28 days. Before this score is adopted in clinical practice, further research is needed for external validation, assessment of accuracy in an office setting, and determination of clinical utility.},
keywords = {*Post-Concussion Syndrome/di [Diagnosis], Accidents, Adolescent, Age Factors, Area Under Curve, Athletic Injuries/co [Complications], Brain Concussion/di [Diagnosis], Brain Concussion/et [Etiology], Child, Emergency Service, Female, Follow-Up Studies, Hospital, Humans, Male, MEDICAL history taking, MULTIVARIATE analysis, Observer Variation, Outcome Assessment (Health Care), Post-Concussion Syndrome/et [Etiology], Preschool, Prospective Studies, RISK assessment, Sensitivity and Specificity, Sex Factors, Time Factors, Traffic/sn [Statistics \& Numerical Data},
pubstate = {published},
tppubtype = {article}
}
Billock, R M; Anderegg, J J; Mehan, T J; Chounthirath, T; Smith, G A
Zipline-related injuries treated in US EDs, 1997-2012 Journal Article
In: American Journal of Emergency Medicine, vol. 33, no. 12, pp. 1745–1749, 2015.
Abstract | Links | BibTeX | Tags: Accidental Falls, Adolescent, adult, arm fracture, Article, body regions, Child, Concussion, emergency health service, Emergency Service, emergency ward, EPIDEMIOLOGY, falling, Female, head and neck injury, head injury, Hospital, hospitalization, human, Humans, Infant, leg injury, major clinical study, Male, Newborn, Preschool, preschool child, priority journal, recreation, residential area, SAFETY, soft tissue injury, sport injury, sprain, statistics and numerical data, trunk injury, UNITED States, Wounds and Injuries, Young Adult, zipline related injury
@article{Billock2015,
title = {Zipline-related injuries treated in US EDs, 1997-2012},
author = {Billock, R M and Anderegg, J J and Mehan, T J and Chounthirath, T and Smith, G A},
doi = {10.1016/j.ajem.2015.08.022},
year = {2015},
date = {2015-01-01},
journal = {American Journal of Emergency Medicine},
volume = {33},
number = {12},
pages = {1745--1749},
abstract = {Purpose To investigate the epidemiology of zipline-related injuries in the United States. Basic Procedures The National Electronic Injury Surveillance System database was used to examine non-fatal zipline-related injuries treated in US emergency departments (EDs) from 1997 through 2012. Sample weights were applied to calculate national estimates. Main Findings From 1997 through 2012, an estimated 16 850 (95% CI, 13 188-20 512) zipline-related injuries were treated in US EDs. The annual injury rate per 1 million population increased by 52.3% from 7.64 (95% CI, 4.86-10.42) injuries in 2009 (the first year with a stable annual estimate) to 11.64 (95% CI, 7.83-15.45) injuries in 2012. Patients aged 0-9 years accounted for 45.0% of injuries, females made up 53.1% of injuries, and 11.7% of patients required hospitalization. Fractures accounted for the largest proportion of injuries (46.7%), and the upper extremities were the most commonly injured body region (44.1%). Falls were the most common mechanism of injury, accounting for 77.3% of injuries. Among cases where the location of the injury event was known, 30.8% of injuries occurred in a residential setting and 69.2% occurred in a public place. Principal Conclusions This study is the first to characterize the epidemiology of zipline-related injuries using a nationally representative database. The rapid increase in zipline-related injuries in recent years suggests the need for additional safety guidelines and regulations. Commercial ziplines and publicly accessible non-commercial ziplines should be subject to uniform safety standards in all states and jurisdictions across the US, and homemade ziplines should not be used. © 2015 Elsevier Inc.},
keywords = {Accidental Falls, Adolescent, adult, arm fracture, Article, body regions, Child, Concussion, emergency health service, Emergency Service, emergency ward, EPIDEMIOLOGY, falling, Female, head and neck injury, head injury, Hospital, hospitalization, human, Humans, Infant, leg injury, major clinical study, Male, Newborn, Preschool, preschool child, priority journal, recreation, residential area, SAFETY, soft tissue injury, sport injury, sprain, statistics and numerical data, trunk injury, UNITED States, Wounds and Injuries, Young Adult, zipline related injury},
pubstate = {published},
tppubtype = {article}
}
Hoffer, M E; Szczupak, M; Kiderman, A; Crawford, J; Murphy, S; Marshall, K; Pelusso, C; Balaban, C
Neurosensory Symptom Complexes after Acute Mild Traumatic Brain Injury Journal Article
In: PLoS ONE, vol. 11, no. 1, pp. e0146039, 2016.
@article{Hoffer2016,
title = {Neurosensory Symptom Complexes after Acute Mild Traumatic Brain Injury},
author = {Hoffer, M E and Szczupak, M and Kiderman, A and Crawford, J and Murphy, S and Marshall, K and Pelusso, C and Balaban, C},
year = {2016},
date = {2016-01-01},
journal = {PLoS ONE},
volume = {11},
number = {1},
pages = {e0146039},
abstract = {Mild Traumatic Brain Injury (mTBI) is a prominent public health issue. To date, subjective symptom complaints primarily dictate diagnostic and treatment approaches. As such, the description and qualification of these symptoms in the mTBI patient population is of great value. This manuscript describes the symptoms of mTBI patients as compared to controls in a larger study designed to examine the use of vestibular testing to diagnose mTBI. Five symptom clusters were identified: Post-Traumatic Headache/Migraine, Nausea, Emotional/Affective, Fatigue/Malaise, and Dizziness/Mild Cognitive Impairment. Our analysis indicates that individuals with mTBI have headache, dizziness, and cognitive dysfunction far out of proportion to those without mTBI. In addition, sleep disorders and emotional issues were significantly more common amongst mTBI patients than non-injured individuals. A simple set of questions inquiring about dizziness, headache, and cognitive issues may provide diagnostic accuracy. The consideration of other symptoms may be critical for providing prognostic value and treatment for best short-term outcomes or prevention of long-term complications.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Zemek, R; Barrowman, N; Freedman, S B; Gravel, J; Gagnon, I; McGahern, C; Aglipay, M; Sangha, G; Boutis, K; Beer, D; Craig, W; Burns, E; Farion, K J; Mikrogianakis, A; Barlow, K; Dubrovsky, A S; Meeuwisse, W; Gioia, G; Meehan 3rd, W P; Beauchamp, M H; Kamil, Y; Grool, A M; Hoshizaki, B; Anderson, P; Brooks, B L; Yeates, K O; Vassilyadi, M; Klassen, T; Keightley, M; Richer, L; DeMatteo, C; Osmond, M H; Pediatric Emergency Research Canada Concussion, Team
Clinical Risk Score for Persistent Postconcussion Symptoms Among Children With Acute Concussion in the ED Journal Article
In: JAMA, vol. 315, no. 10, pp. 1014–1025, 2016.
@article{Zemek2016,
title = {Clinical Risk Score for Persistent Postconcussion Symptoms Among Children With Acute Concussion in the ED},
author = {Zemek, R and Barrowman, N and Freedman, S B and Gravel, J and Gagnon, I and McGahern, C and Aglipay, M and Sangha, G and Boutis, K and Beer, D and Craig, W and Burns, E and Farion, K J and Mikrogianakis, A and Barlow, K and Dubrovsky, A S and Meeuwisse, W and Gioia, G and {Meehan 3rd}, W P and Beauchamp, M H and Kamil, Y and Grool, A M and Hoshizaki, B and Anderson, P and Brooks, B L and Yeates, K O and Vassilyadi, M and Klassen, T and Keightley, M and Richer, L and DeMatteo, C and Osmond, M H and {Pediatric Emergency Research Canada Concussion}, Team},
year = {2016},
date = {2016-01-01},
journal = {JAMA},
volume = {315},
number = {10},
pages = {1014--1025},
abstract = {IMPORTANCE: Approximately one-third of children experiencing acute concussion experience ongoing somatic, cognitive, and psychological or behavioral symptoms, referred to as persistent postconcussion symptoms (PPCS). However, validated and pragmatic tools enabling clinicians to identify patients at risk for PPCS do not exist. OBJECTIVE: To derive and validate a clinical risk score for PPCS among children presenting to the emergency department. DESIGN, SETTING, AND PARTICIPANTS: Prospective, multicenter cohort study (Predicting and Preventing Postconcussive Problems in Pediatrics [5P]) enrolled young patients (aged 5-\<18 years) who presented within 48 hours of an acute head injury at 1 of 9 pediatric emergency departments within the Pediatric Emergency Research Canada (PERC) network from August 2013 through September 2014 (derivation cohort) and from October 2014 through June 2015 (validation cohort). Participants completed follow-up 28 days after the injury. EXPOSURES: All eligible patients had concussions consistent with the Zurich consensus diagnostic criteria. MAIN OUTCOMES AND MEASURES: The primary outcome was PPCS risk score at 28 days, which was defined as 3 or more new or worsening symptoms using the patient-reported Postconcussion Symptom Inventory compared with recalled state of being prior to the injury. RESULTS: In total, 3063 patients (median age, 12.0 years [interquartile range, 9.2-14.6 years]; 1205 [39.3%] girls) were enrolled (n=2006 in the derivation cohort; n=1057 in the validation cohort) and 2584 of whom (n=1701 [85%] in the derivation cohort; n=883 [84%] in the validation cohort) completed follow-up at 28 days after the injury. Persistent postconcussion symptoms were present in 801 patients (31.0%) (n=510 [30.0%] in the derivation cohort and n=291 [33.0%] in the validation cohort). The 12-point PPCS risk score model for the derivation cohort included the variables of female sex, age of 13 years or older, physician-diagnosed migraine history, prior concussion with symptoms lasting longer than 1 week, headache, sensitivity to noise, fatigue, answering questions slowly, and 4 or more errors on the Balance Error Scoring System tandem stance. The area under the curve was 0.71 (95% CI, 0.69-0.74) for the derivation cohort and 0.68 (95% CI, 0.65-0.72) for the validation cohort. CONCLUSIONS AND RELEVANCE: A clinical risk score developed among children presenting to the emergency department with concussion and head injury within the previous 48 hours had modest discrimination to stratify PPCS risk at 28 days. Before this score is adopted in clinical practice, further research is needed for external validation, assessment of accuracy in an office setting, and determination of clinical utility.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Billock, R M; Anderegg, J J; Mehan, T J; Chounthirath, T; Smith, G A
Zipline-related injuries treated in US EDs, 1997-2012 Journal Article
In: American Journal of Emergency Medicine, vol. 33, no. 12, pp. 1745–1749, 2015.
@article{Billock2015,
title = {Zipline-related injuries treated in US EDs, 1997-2012},
author = {Billock, R M and Anderegg, J J and Mehan, T J and Chounthirath, T and Smith, G A},
doi = {10.1016/j.ajem.2015.08.022},
year = {2015},
date = {2015-01-01},
journal = {American Journal of Emergency Medicine},
volume = {33},
number = {12},
pages = {1745--1749},
abstract = {Purpose To investigate the epidemiology of zipline-related injuries in the United States. Basic Procedures The National Electronic Injury Surveillance System database was used to examine non-fatal zipline-related injuries treated in US emergency departments (EDs) from 1997 through 2012. Sample weights were applied to calculate national estimates. Main Findings From 1997 through 2012, an estimated 16 850 (95% CI, 13 188-20 512) zipline-related injuries were treated in US EDs. The annual injury rate per 1 million population increased by 52.3% from 7.64 (95% CI, 4.86-10.42) injuries in 2009 (the first year with a stable annual estimate) to 11.64 (95% CI, 7.83-15.45) injuries in 2012. Patients aged 0-9 years accounted for 45.0% of injuries, females made up 53.1% of injuries, and 11.7% of patients required hospitalization. Fractures accounted for the largest proportion of injuries (46.7%), and the upper extremities were the most commonly injured body region (44.1%). Falls were the most common mechanism of injury, accounting for 77.3% of injuries. Among cases where the location of the injury event was known, 30.8% of injuries occurred in a residential setting and 69.2% occurred in a public place. Principal Conclusions This study is the first to characterize the epidemiology of zipline-related injuries using a nationally representative database. The rapid increase in zipline-related injuries in recent years suggests the need for additional safety guidelines and regulations. Commercial ziplines and publicly accessible non-commercial ziplines should be subject to uniform safety standards in all states and jurisdictions across the US, and homemade ziplines should not be used. © 2015 Elsevier Inc.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Hoffer, M E; Szczupak, M; Kiderman, A; Crawford, J; Murphy, S; Marshall, K; Pelusso, C; Balaban, C
Neurosensory Symptom Complexes after Acute Mild Traumatic Brain Injury Journal Article
In: PLoS ONE, vol. 11, no. 1, pp. e0146039, 2016.
Abstract | BibTeX | Tags: *Brain Injuries/co [Complications], *Vestibular Function Tests, acute disease, Adolescent, adult, Affective Symptoms/et [Etiology], Brain Injuries/di [Diagnosis], Cluster Analysis, Dizziness/et [Etiology], Emergency Service, Fatigue/et [Etiology], Female, Gait Disorders, Headache/et [Etiology], Hospital, Hospitals, Humans, Male, middle aged, Mild Cognitive Impairment/et [Etiology], Military, Nausea/et [Etiology], Neurologic/et [Etiology], Neuropsychological Tests, Principal Component Analysis, Prognosis, Sex Factors, Surveys and Questionnaires, symptom assessment, Trauma Severity Indices, university, Young Adult
@article{Hoffer2016,
title = {Neurosensory Symptom Complexes after Acute Mild Traumatic Brain Injury},
author = {Hoffer, M E and Szczupak, M and Kiderman, A and Crawford, J and Murphy, S and Marshall, K and Pelusso, C and Balaban, C},
year = {2016},
date = {2016-01-01},
journal = {PLoS ONE},
volume = {11},
number = {1},
pages = {e0146039},
abstract = {Mild Traumatic Brain Injury (mTBI) is a prominent public health issue. To date, subjective symptom complaints primarily dictate diagnostic and treatment approaches. As such, the description and qualification of these symptoms in the mTBI patient population is of great value. This manuscript describes the symptoms of mTBI patients as compared to controls in a larger study designed to examine the use of vestibular testing to diagnose mTBI. Five symptom clusters were identified: Post-Traumatic Headache/Migraine, Nausea, Emotional/Affective, Fatigue/Malaise, and Dizziness/Mild Cognitive Impairment. Our analysis indicates that individuals with mTBI have headache, dizziness, and cognitive dysfunction far out of proportion to those without mTBI. In addition, sleep disorders and emotional issues were significantly more common amongst mTBI patients than non-injured individuals. A simple set of questions inquiring about dizziness, headache, and cognitive issues may provide diagnostic accuracy. The consideration of other symptoms may be critical for providing prognostic value and treatment for best short-term outcomes or prevention of long-term complications.},
keywords = {*Brain Injuries/co [Complications], *Vestibular Function Tests, acute disease, Adolescent, adult, Affective Symptoms/et [Etiology], Brain Injuries/di [Diagnosis], Cluster Analysis, Dizziness/et [Etiology], Emergency Service, Fatigue/et [Etiology], Female, Gait Disorders, Headache/et [Etiology], Hospital, Hospitals, Humans, Male, middle aged, Mild Cognitive Impairment/et [Etiology], Military, Nausea/et [Etiology], Neurologic/et [Etiology], Neuropsychological Tests, Principal Component Analysis, Prognosis, Sex Factors, Surveys and Questionnaires, symptom assessment, Trauma Severity Indices, university, Young Adult},
pubstate = {published},
tppubtype = {article}
}
Zemek, R; Barrowman, N; Freedman, S B; Gravel, J; Gagnon, I; McGahern, C; Aglipay, M; Sangha, G; Boutis, K; Beer, D; Craig, W; Burns, E; Farion, K J; Mikrogianakis, A; Barlow, K; Dubrovsky, A S; Meeuwisse, W; Gioia, G; Meehan 3rd, W P; Beauchamp, M H; Kamil, Y; Grool, A M; Hoshizaki, B; Anderson, P; Brooks, B L; Yeates, K O; Vassilyadi, M; Klassen, T; Keightley, M; Richer, L; DeMatteo, C; Osmond, M H; Pediatric Emergency Research Canada Concussion, Team
Clinical Risk Score for Persistent Postconcussion Symptoms Among Children With Acute Concussion in the ED Journal Article
In: JAMA, vol. 315, no. 10, pp. 1014–1025, 2016.
Abstract | BibTeX | Tags: *Post-Concussion Syndrome/di [Diagnosis], Accidents, Adolescent, Age Factors, Area Under Curve, Athletic Injuries/co [Complications], Brain Concussion/di [Diagnosis], Brain Concussion/et [Etiology], Child, Emergency Service, Female, Follow-Up Studies, Hospital, Humans, Male, MEDICAL history taking, MULTIVARIATE analysis, Observer Variation, Outcome Assessment (Health Care), Post-Concussion Syndrome/et [Etiology], Preschool, Prospective Studies, RISK assessment, Sensitivity and Specificity, Sex Factors, Time Factors, Traffic/sn [Statistics & Numerical Data
@article{Zemek2016,
title = {Clinical Risk Score for Persistent Postconcussion Symptoms Among Children With Acute Concussion in the ED},
author = {Zemek, R and Barrowman, N and Freedman, S B and Gravel, J and Gagnon, I and McGahern, C and Aglipay, M and Sangha, G and Boutis, K and Beer, D and Craig, W and Burns, E and Farion, K J and Mikrogianakis, A and Barlow, K and Dubrovsky, A S and Meeuwisse, W and Gioia, G and {Meehan 3rd}, W P and Beauchamp, M H and Kamil, Y and Grool, A M and Hoshizaki, B and Anderson, P and Brooks, B L and Yeates, K O and Vassilyadi, M and Klassen, T and Keightley, M and Richer, L and DeMatteo, C and Osmond, M H and {Pediatric Emergency Research Canada Concussion}, Team},
year = {2016},
date = {2016-01-01},
journal = {JAMA},
volume = {315},
number = {10},
pages = {1014--1025},
abstract = {IMPORTANCE: Approximately one-third of children experiencing acute concussion experience ongoing somatic, cognitive, and psychological or behavioral symptoms, referred to as persistent postconcussion symptoms (PPCS). However, validated and pragmatic tools enabling clinicians to identify patients at risk for PPCS do not exist. OBJECTIVE: To derive and validate a clinical risk score for PPCS among children presenting to the emergency department. DESIGN, SETTING, AND PARTICIPANTS: Prospective, multicenter cohort study (Predicting and Preventing Postconcussive Problems in Pediatrics [5P]) enrolled young patients (aged 5-\<18 years) who presented within 48 hours of an acute head injury at 1 of 9 pediatric emergency departments within the Pediatric Emergency Research Canada (PERC) network from August 2013 through September 2014 (derivation cohort) and from October 2014 through June 2015 (validation cohort). Participants completed follow-up 28 days after the injury. EXPOSURES: All eligible patients had concussions consistent with the Zurich consensus diagnostic criteria. MAIN OUTCOMES AND MEASURES: The primary outcome was PPCS risk score at 28 days, which was defined as 3 or more new or worsening symptoms using the patient-reported Postconcussion Symptom Inventory compared with recalled state of being prior to the injury. RESULTS: In total, 3063 patients (median age, 12.0 years [interquartile range, 9.2-14.6 years]; 1205 [39.3%] girls) were enrolled (n=2006 in the derivation cohort; n=1057 in the validation cohort) and 2584 of whom (n=1701 [85%] in the derivation cohort; n=883 [84%] in the validation cohort) completed follow-up at 28 days after the injury. Persistent postconcussion symptoms were present in 801 patients (31.0%) (n=510 [30.0%] in the derivation cohort and n=291 [33.0%] in the validation cohort). The 12-point PPCS risk score model for the derivation cohort included the variables of female sex, age of 13 years or older, physician-diagnosed migraine history, prior concussion with symptoms lasting longer than 1 week, headache, sensitivity to noise, fatigue, answering questions slowly, and 4 or more errors on the Balance Error Scoring System tandem stance. The area under the curve was 0.71 (95% CI, 0.69-0.74) for the derivation cohort and 0.68 (95% CI, 0.65-0.72) for the validation cohort. CONCLUSIONS AND RELEVANCE: A clinical risk score developed among children presenting to the emergency department with concussion and head injury within the previous 48 hours had modest discrimination to stratify PPCS risk at 28 days. Before this score is adopted in clinical practice, further research is needed for external validation, assessment of accuracy in an office setting, and determination of clinical utility.},
keywords = {*Post-Concussion Syndrome/di [Diagnosis], Accidents, Adolescent, Age Factors, Area Under Curve, Athletic Injuries/co [Complications], Brain Concussion/di [Diagnosis], Brain Concussion/et [Etiology], Child, Emergency Service, Female, Follow-Up Studies, Hospital, Humans, Male, MEDICAL history taking, MULTIVARIATE analysis, Observer Variation, Outcome Assessment (Health Care), Post-Concussion Syndrome/et [Etiology], Preschool, Prospective Studies, RISK assessment, Sensitivity and Specificity, Sex Factors, Time Factors, Traffic/sn [Statistics \& Numerical Data},
pubstate = {published},
tppubtype = {article}
}
Billock, R M; Anderegg, J J; Mehan, T J; Chounthirath, T; Smith, G A
Zipline-related injuries treated in US EDs, 1997-2012 Journal Article
In: American Journal of Emergency Medicine, vol. 33, no. 12, pp. 1745–1749, 2015.
Abstract | Links | BibTeX | Tags: Accidental Falls, Adolescent, adult, arm fracture, Article, body regions, Child, Concussion, emergency health service, Emergency Service, emergency ward, EPIDEMIOLOGY, falling, Female, head and neck injury, head injury, Hospital, hospitalization, human, Humans, Infant, leg injury, major clinical study, Male, Newborn, Preschool, preschool child, priority journal, recreation, residential area, SAFETY, soft tissue injury, sport injury, sprain, statistics and numerical data, trunk injury, UNITED States, Wounds and Injuries, Young Adult, zipline related injury
@article{Billock2015,
title = {Zipline-related injuries treated in US EDs, 1997-2012},
author = {Billock, R M and Anderegg, J J and Mehan, T J and Chounthirath, T and Smith, G A},
doi = {10.1016/j.ajem.2015.08.022},
year = {2015},
date = {2015-01-01},
journal = {American Journal of Emergency Medicine},
volume = {33},
number = {12},
pages = {1745--1749},
abstract = {Purpose To investigate the epidemiology of zipline-related injuries in the United States. Basic Procedures The National Electronic Injury Surveillance System database was used to examine non-fatal zipline-related injuries treated in US emergency departments (EDs) from 1997 through 2012. Sample weights were applied to calculate national estimates. Main Findings From 1997 through 2012, an estimated 16 850 (95% CI, 13 188-20 512) zipline-related injuries were treated in US EDs. The annual injury rate per 1 million population increased by 52.3% from 7.64 (95% CI, 4.86-10.42) injuries in 2009 (the first year with a stable annual estimate) to 11.64 (95% CI, 7.83-15.45) injuries in 2012. Patients aged 0-9 years accounted for 45.0% of injuries, females made up 53.1% of injuries, and 11.7% of patients required hospitalization. Fractures accounted for the largest proportion of injuries (46.7%), and the upper extremities were the most commonly injured body region (44.1%). Falls were the most common mechanism of injury, accounting for 77.3% of injuries. Among cases where the location of the injury event was known, 30.8% of injuries occurred in a residential setting and 69.2% occurred in a public place. Principal Conclusions This study is the first to characterize the epidemiology of zipline-related injuries using a nationally representative database. The rapid increase in zipline-related injuries in recent years suggests the need for additional safety guidelines and regulations. Commercial ziplines and publicly accessible non-commercial ziplines should be subject to uniform safety standards in all states and jurisdictions across the US, and homemade ziplines should not be used. © 2015 Elsevier Inc.},
keywords = {Accidental Falls, Adolescent, adult, arm fracture, Article, body regions, Child, Concussion, emergency health service, Emergency Service, emergency ward, EPIDEMIOLOGY, falling, Female, head and neck injury, head injury, Hospital, hospitalization, human, Humans, Infant, leg injury, major clinical study, Male, Newborn, Preschool, preschool child, priority journal, recreation, residential area, SAFETY, soft tissue injury, sport injury, sprain, statistics and numerical data, trunk injury, UNITED States, Wounds and Injuries, Young Adult, zipline related injury},
pubstate = {published},
tppubtype = {article}
}