title: A population-based study of paediatric emergency department and office visits for concussions from 2003 to 2010.
abstract: BACKGROUND
  There is a paucity of information regarding descriptive epidemiology of paediatric concussions over time, and few studies include both emergency department (ED) and physician office visits.
  
  
  OBJECTIVE
  To describe trends in visits for paediatric concussions in both EDs and physician offices according to age and sex. A secondary objective was to describe the cause of concussion for children treated in EDs.
  
  
  METHODS
  A retrospective, population-based study using linked health administrative data from all concussion-related visits to the ED or a physician office by school-age children and youth (three to 18 years of age) in Ontario between April 1, 2003 and March 3, 2011 was conducted.
  
  
  RESULTS
  The number of children evaluated in both EDs and a physician offices increased between 2003 and 2010, and this linear trend was statistically significant (P=0.002 for ED visits and P=0.001 for office visits). The rate per 100,000 increased from 466.7 to 754.3 for boys and from 208.6 to 440.7 for girls during the study period. Falls accounted for approximately one-third of the paediatric concussions. Hockey/skating was the most common specific cause of paediatric sports-related concussions.
  
  
  CONCLUSIONS
  The increasing use of health care services for concussions is likely related to changes in incidence over time and increased awareness of concussion as a health issue. Evidence-based prevention initiatives to help reduce the incidence of concussion are warranted, particularly in sports and recreation programs.
authors.affiliation: York University; ; Institute for Clinical Evaluative Sciences, The Hospital for Sick Children and Department of Paediatrics, University of Toronto, Toronto, Ontario.
authors.forename: Alison
authors.initials: A
authors.lastname: Macpherson
authors.affiliation: York University;
authors.forename: Liraz
authors.initials: L
authors.lastname: Fridman
authors.affiliation: York University;
authors.forename: Michal
authors.initials: M
authors.lastname: Scolnik
authors.affiliation: Institute for Clinical Evaluative Sciences, The Hospital for Sick Children and Department of Paediatrics, University of Toronto, Toronto, Ontario.
authors.forename: Ashley
authors.initials: A
authors.lastname: Corallo
authors.affiliation: Institute for Clinical Evaluative Sciences, The Hospital for Sick Children and Department of Paediatrics, University of Toronto, Toronto, Ontario ; Division of Paediatric Medicine, The Hospital for Sick Children and Department of Paediatrics, University of Toronto, Toronto, Ontario.
authors.forename: Astrid
authors.initials: A
authors.lastname: Guttmann
keywords: Concussion; Concussion-related injury; Epidemiology; Paediatric