Go to content

Annual trends in follow-up visits for pediatric concussion in emergency departments and physicians’ offices


Objective — To assess whether children and youth with concussion receive follow-up visits in accordance with the recommended guidelines.

Study Design
— We conducted a retrospective, population-based study using linked health administrative data from all concussion-related visits to emergency department and physician offices by children aged 5 through 18 years (range, 5.00-18.99) in Ontario between 2003 and 2013. We analyzed the percentage of children and youth seen for follow-up. The Mann-Kendall test for trends was used to assess a monotonic increasing trend over time in concussion follow-up visits.

— A total of 126 654 children and youth were evaluated for an index concussion visit. The number of children and youth assessed for concussion follow-up (N = 45 155) has increased significantly over time (P < .001). In 2003, 781 of 7126 patients (11.0%; 95% CI, 10.3-11.7) with an index visit for concussion had a follow-up assessment. By 2013, 6526 of 21 681 (30.1%; 95% CI, 29.5-30.7) patients received follow-up care.

— The proportion of children and youth receiving follow-up after an acute concussion has significantly increased between 2003 and 2013. Nevertheless, more than two-thirds of all patients do not seek medical follow-up or clearance as recommended by current concussion guidelines, suggesting that ongoing efforts to improve and monitor compliance with recommended guidelines by patients and physicians are important.



Fridman L, Scolnik M, Macpherson A, Rothman L, Guttmann A, Grool AM, Duque DR, Zemek RL. J Pediatr. 2018; 192:184-8. Epub 2017 Nov 14.

Contributing ICES Scientists

Associated Sites