Inappropriate discharge instructions for youth athletes hospitalized for concussion.
OBJECTIVE
To evaluate the medical care, especially the discharge instructions regarding return to participation, received by youth athletes hospitalized for a closed head injury.


METHODS
We examined the records of all patients admitted over a 5-year period (1987 through 1991) to The Children's Hospital of Alabama for a sports-related closed head injury. Descriptive information was recorded and discharge instructions reviewed. Injury severity was graded according to guidelines current during the study period, as well as those outlined most recently by the Colorado Medical Society, which have been endorsed by a number of organizations including the American Academy of Pediatrics. Discharge instructions recorded for each patient were then compared with those recommended in the guidelines.


RESULTS
We identified 33 patients with sports-related closed head injuries. Grade 1 concussions (least severe) occurred in 8 patients (24.2%), grade 2 in 10 (30.3%), and grade 3 (most severe) in 15 (45.4%). Overall, discharge instructions were appropriate for only 10 patients (30.3%), including all with grade 1 concussions, but only 2 with a grade 2 (20.0%) and none with a grade 3 concussion.


CONCLUSIONS
All who care for youth athletes must become familiar with the guidelines for management of concussion to provide appropriate care and counseling and to avoid a tragic outcome.
Department of Pediatrics, University of Alabama at Birmingham.
F J
FJ
Genuardi
W D
WD
King
D000293:Adolescent; D000407:Alabama; D001265:Athletic Injuries / Q000453:epidemiology / Q000628:therapy*; D001924:Brain Concussion / Q000453:epidemiology / Q000209:etiology / Q000628:therapy*; D002648:Child; D005260:Female; D006760:Hospitalization; D006776:Hospitals, Pediatric; D006801:Humans; D008297:Male; D008485:Medical Audit; D010351:Patient Discharge; D010353:Patient Education as Topic; D017410:Practice Guidelines as Topic; D013997:Time Factors; D015599:Trauma Severity Indices