title: Multidisciplinary Management of Pediatric Sports-Related Concussion.
abstract: OBJECTIVE
  To summarize the clinical characteristics and outcomes of pediatric sports-related concussion (SRC) patients who were evaluated and managed at a multidisciplinary pediatric concussion program and examine the healthcare resources and personnel required to meet the needs of this patient population.
  
  
  METHODS
  We conducted a retrospective review of all pediatric SRC patients referred to the Pan Am Concussion Program from September 1st, 2013 to May 25th, 2015. Initial assessments and diagnoses were carried out by a single neurosurgeon. Return-to-Play decision-making was carried out by the multidisciplinary team.
  
  
  RESULTS
  604 patients, including 423 pediatric SRC patients were evaluated at the Pan Am Concussion Program during the study period. The mean age of study patients was 14.30 years (SD: 2.32, range 7-19 years); 252 (59.57%) were males. Hockey (182; 43.03%) and soccer (60; 14.18%) were the most commonly played sports at the time of injury. Overall, 294 (69.50%) of SRC patients met the clinical criteria for concussion recovery, while 75 (17.73%) were lost to follow-up, and 53 (12.53%) remained in active treatment at the end of the study period. The median duration of symptoms among the 261 acute SRC patients with complete follow-up was 23 days (IQR: 15, 36). Overall, 25.30% of pediatric SRC patients underwent at least one diagnostic imaging test and 32.62% received referral to another member of our multidisciplinary clinical team.
  
  
  CONCLUSIONS
  Comprehensive care of pediatric SRC patients requires access to appropriate diagnostic resources and the multidisciplinary collaboration of experts with national and provincially-recognized training in TBI.
authors: 1Department of Surgery,University of Manitoba,Winnipeg,Manitoba,Canada.
authors: Michael J
authors: MJ
authors: Ellis
authors: 3Clinical Health Psychology,University of Manitoba,Winnipeg,Manitoba,Canada.
authors: Lesley J
authors: LJ
authors: Ritchie
authors: 1Department of Surgery,University of Manitoba,Winnipeg,Manitoba,Canada.
authors: Patrick J
authors: PJ
authors: McDonald
authors: 10Pan Am Clinic and Pan Am Concussion Program,Winnipeg,Manitoba,Canada.
authors: Dean
authors: D
authors: Cordingley
authors: 4Rehabilitation Sciences,University of Manitoba,Winnipeg,Manitoba,Canada.
authors: Karen
authors: K
authors: Reimer
authors: 5Neurology,University of Manitoba,Winnipeg,Manitoba,Canada.
authors: Satnam
authors: S
authors: Nijjar
authors: 6Psychiatry,University of Manitoba,Winnipeg,Manitoba,Canada.
authors: Mark
authors: M
authors: Koltek
authors: 6Psychiatry,University of Manitoba,Winnipeg,Manitoba,Canada.
authors: Shahid
authors: S
authors: Hosain
authors: 5Neurology,University of Manitoba,Winnipeg,Manitoba,Canada.
authors: Janine
authors: J
authors: Johnston
authors: 5Neurology,University of Manitoba,Winnipeg,Manitoba,Canada.
authors: Behzad
authors: B
authors: Mansouri
authors: 2Pediatrics and Child Health,University of Manitoba,Winnipeg,Manitoba,Canada.
authors: Scott
authors: S
authors: Sawyer
authors: 2Pediatrics and Child Health,University of Manitoba,Winnipeg,Manitoba,Canada.
authors: Norm
authors: N
authors: Silver
authors: 10Pan Am Clinic and Pan Am Concussion Program,Winnipeg,Manitoba,Canada.
authors: Richard
authors: R
authors: Girardin
authors: 4Rehabilitation Sciences,University of Manitoba,Winnipeg,Manitoba,Canada.
authors: Shannon
authors: S
authors: Larkins
authors: 10Pan Am Clinic and Pan Am Concussion Program,Winnipeg,Manitoba,Canada.
authors: Sara
authors: S
authors: Vis
authors: 2Pediatrics and Child Health,University of Manitoba,Winnipeg,Manitoba,Canada.
authors: Erin
authors: E
authors: Selci
authors: 7Diagnostic Imaging,University of Manitoba,Winnipeg,Manitoba,Canada.
authors: Michael
authors: M
authors: Davidson
authors: 7Diagnostic Imaging,University of Manitoba,Winnipeg,Manitoba,Canada.
authors: Scott
authors: S
authors: Gregoire
authors: 7Diagnostic Imaging,University of Manitoba,Winnipeg,Manitoba,Canada.
authors: Angela
authors: A
authors: Sam
authors: 1Department of Surgery,University of Manitoba,Winnipeg,Manitoba,Canada.
authors: Brian
authors: B
authors: Black
authors: 2Pediatrics and Child Health,University of Manitoba,Winnipeg,Manitoba,Canada.
authors: Martin
authors: M
authors: Bunge
authors: 7Diagnostic Imaging,University of Manitoba,Winnipeg,Manitoba,Canada.
authors: Marco
authors: M
authors: Essig
authors: 9Orthopedics,University of Manitoba,Winnipeg,Manitoba,Canada.
authors: Peter
authors: P
authors: MacDonald
authors: 1Department of Surgery,University of Manitoba,Winnipeg,Manitoba,Canada.
authors: Jeff
authors: J
authors: Leiter
authors: 2Pediatrics and Child Health,University of Manitoba,Winnipeg,Manitoba,Canada.
authors: Kelly
authors: K
authors: Russell
mesh_terms: D000293:Adolescent; D001265:Athletic Injuries / Q000150:complications* / Q000453:epidemiology; D001924:Brain Concussion / Q000453:epidemiology / Q000209:etiology / Q000628:therapy; D002648:Child; D019468:Disease Management; D005260:Female; D006801:Humans; D008297:Male; D010175:Pan American Health Organization; D012189:Retrospective Studies
keywords: Sports-related concussion; concussion program; healthcare utilization; multidisciplinary; pediatric; traumatic brain injury