title: Discharge instructions for youth sports-related concussions in the emergency department, 2004 to 2012.
abstract: OBJECTIVE
  To evaluate the effect of the Centers for Disease Control and Prevention (CDC) Heads-Up concussion campaign on appropriateness of discharge instructions for youth sports-related concussion (SRC) patients presenting to a pediatric emergency department (ED).
  
  
  METHODS
  Retrospective cohort study.
  
  
  METHODS
  Pediatric ED.
  
  
  METHODS
  Children up to 18 years.
  
  
  METHODS
  A retrospective chart review was conducted on patients evaluated from 2004 to 2012. Patients were selected by ICD-9 code for having a concussion during a sporting activity.
  
  
  METHODS
  Discharge instructions were reviewed for recommendations for cognitive rest, physical rest, primary care physician follow-up, and referral to a concussion specialist or center.
  
  
  RESULTS
  There were 497 youth SRCs from 392 908 total ED visits. Overall, only 66% had appropriate discharge recommendations. This improved to 75% after 2010, which was not statistically significant (odds ratio = 1.02, P = 0.179). Only 4% of patients received a recommendation of cognitive rest, which only increased to 12% of the patients seen after 2010. Finally, referrals to a sports concussion specialist or center dramatically increased from an average of 8% to 43% after 2010.
  
  
  CONCLUSIONS
  Even with the CDC Heads-Up campaign on concussion education, there is still need to improve appropriateness of discharge instructions for youth SRCs. There have been dramatic increases in referrals to sports concussion specialists and centers after 2010.
authors: *Vanderbilt School of Medicine, Nashville, Tennessee; and †Department of Pediatric Orthopaedic Surgery, C.S. Mott Children's Hospital, Ann Arbor, Michigan.
authors: Cameron
authors: C
authors: Upchurch
authors: Clinton D
authors: CD
authors: Morgan
authors: Allison
authors: A
authors: Umfress
authors: George
authors: G
authors: Yang
authors: Mark F
authors: MF
authors: Riederer
mesh_terms: D000293:Adolescent; D001265:Athletic Injuries / Q000534:rehabilitation*; D001924:Brain Concussion / Q000534:rehabilitation*; D002648:Child; D004636:Emergency Service, Hospital / Q000592:standards / Q000706:statistics & numerical data*; D006801:Humans; D063886:Patient Discharge Summaries / Q000592:standards / Q000706:statistics & numerical data*; D012189:Retrospective Studies