Characterizing the profiles of patients with acute concussion versus prolonged post-concussion symptoms in Ontario.

Identifying vulnerability factors for developing persisting concussion symptoms is imperative for determining which patients may require specialized treatment. Using cross-sectional questionnaire data from an Ontario-wide observational concussion study, we compared patients with acute concussion (≤ 14 days) and prolonged post-concussion symptoms (PPCS) (≥ 90 days) on four factors of interest: sex, history of mental health disorders, history of headaches/migraines, and past concussions. Differences in profile between the two groups were also explored. 110 patients with acute concussion and 96 patients with PPCS were included in our study. The groups did not differ on the four factors of interest. Interestingly, both groups had greater proportions of females (acute concussion: 61.1% F; PPCS: 66.3% F). Patient profiles, however, differed wherein patients with PPCS were significantly older, more symptomatic, more likely to have been injured in a transportation-related incident, and more likely to live outside a Metropolitan city. These novel risk factors for persisting concussion symptoms require replication and highlight the need to re-evaluate previously identified risk factors as more and more concussions occur in non-athletes and different risk factors may be at play.

Rising burden of multimorbidity and related socio-demographic factors: a repeated cross-sectional study of Ontarians.

OBJECTIVE: This study aimed to provide population-level data regarding trends in multimorbidity over 13 years. METHODS: We linked provincial health administrative data in Ontario, Canada, to create 3 cross-sectional panels of residents of any age in 2003, 2009, and 2016 to describe: (i) 13-year trends in multimorbidity prevalence and constellations among residents and across age, sex, and income; and (ii) chronic condition clusters. Multimorbidity was defined as having at least any 2 of 18 selected conditions, and further grouped into levels of 2, 3, 4, or 5 or more conditions. Age-sex standardized multimorbidity prevalence was estimated using the 2009 population as the standard. Clustering was defined using the observed combinations of conditions within levels of multimorbidity. RESULTS: Standardized prevalence of multimorbidity increased over time (26.5%, 28.8%, and 30.0% across sequential panels), across sex, age, and area-based income. Females, older adults and those living in lower income areas exhibited higher rates in all years. However, multimorbidity increased relatively more among males, younger adults, and those with 4 or 5 or more conditions. We observed numerous and increasing diversity in disease clusters, namely at higher levels of multimorbidity. CONCLUSION: Our study provides relevant and needed population-based information on the growing burden of multimorbidity, and related socio-demographic risk factors. Multimorbidity is markedly increasing among younger age cohorts. Also, there is an increasing complexity and lack of common clustering patterns at higher multimorbidity levels.

RéSUMé: OBJECTIF: Cette étude a pour but d'offrir des données populationnelles sur la multimorbidité et les tendances sur 13 années. MéTHODES: Cette étude transversale utilise des données administratives provinciales, incluant trois panels d'individus de tous âges, en 2003, 2009 et 2016, pour décrire : (i) les tendances de la multimorbidité en Ontario, et les différences entre âge, sexe et niveaux de revenus; ainsi que (ii) les combinaisons de maladies chroniques. La multimorbidité a été définie comme ayant au moins deux des 18 maladies chroniques sélectionnées, et ensuite groupée par niveau de 2, 3, 4 ou 5 maladies ou plus. Les taux de prévalence standardisés ont été estimés à partir de la population de 2009. Les combinaisons fréquentes de maladies chroniques observées par niveau de multimorbidité sont également arborées. RéSULTATS: La prévalence standardisée de multimorbidité a augmenté au fil des années (26,5 %, 28,8 % et 30,0 %). Elle était plus élevée chez les femmes, les personnes âgées, et celles vivant dans les endroits à faible revenus, peu importe l'année. Toutefois l'augmentation dans le temps était plus importante chez les hommes, les jeunes adultes, et pour les niveaux élevés de multimorbidité (4, 5 ou plus). Nous avons observé un nombre élevé de combinaisons de maladies, et une diversité grandissante spécialement pour les niveaux de multimorbidité élevés. CONCLUSION: Cette étude fournit des données épidémiologiques probantes sur le problème grandissant de la multimorbidité, notamment au sein des jeunes cohortes, et les facteurs sociodémographiques associés. Il existe également une complexité grandissante et pas de profils communs dans les combinaisons de maladies, aux niveaux élevés de multimorbidité.