Characteristics of Pediatric Concussion across Different Mechanisms of Injury in 5 through 12-Year-Olds.

ABSTRACT

OBJECTIVE: To investigate characteristics of sport-related concussion (SRC), recreation-related concussion (RRC), and non-sport or recreation-related concussion (non-SRRC) in patients 5 through 12 years old, an understudied population in youth concussion. STUDY DESIGN: This retrospective, observational study included patients aged 5 through 12 years presenting to a specialty care concussion setting at ≤28 days post-injury form 2018 through 2022. The following characteristics were assessed demographics, injury mechanism (SRC, RRC, or SRRC), point of healthcare entry, and clinical signs and symptoms. Kruskal-Wallis and chi-square tests were used to assess group differences. Post hoc pairwise comparisons were employed for all analyses (α=0.017). RESULTS: 1,141 patients reported at ≤28 days of injury (female=42.9%, median age=11, IQR=9-12) with the most common mechanism being RRC (37.3%), followed by non-SRRC (31.9%). More non-SRRCs (39.6%) and RRC (35.7%) were first seen in the emergency department (p<0.001) compared with SRC (27.9%). Patients with RRC and non-SRRC were first evaluated at specialists 4 and 6 days later than SRC (p<0.001). Patients with non-SRRC reported with higher symptom burden, more frequent visio-vestibular abnormalities, and more changes to sleep and daily habits (p<0.001) compared with RRC and SRC (p<0.001). CONCLUSIONS: In concussion patients 5 through 12 years, RRCs and non-SRRC were more prevalent than SRC, presenting first more commonly to the emergency department and taking longer to present to specialists. Non-SRRC had more severe clinical features. RRC and non-SRRC are distinct from SRC in potential for less supervision at time of injury and less direct access to established concussion health care following injury.