CDC Reports ED Visits for Pediatric Concussions Up 60% over Decade -

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MIKE STOBBE, AP Medical Writer | | Thursday, October 6, 2011

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ATLANTA (AP) — The number of athletic children going to hospitals with concussions is up 60 percent in the past decade, a finding that is likely due to parents and coaches being more careful about treating head injuries, according to a new federal study.

"It's a good increase, if that makes any sense," said Steve Marshall, interim director of the University of North Carolina's Injury Prevention and Research Center.

"These injuries were always there. It's not that there are more injuries now. It's just that now people are getting treatment that they weren't getting before," said Marshall, who was not involved in the new research.

Bicycling and football were the leading reasons for the kids' brain injuries, but health officials said that could be at least partly related to the popularity of those activities. For example, it's possible many more kids bike, so a larger number of bike-related injuries would be expected.

The Centers for Disease Control and Prevention study is based on a survey of 66 hospital emergency departments that was designed to be nationally representative. The CDC looked at non-fatal data for the years 2001 through 2009 for kids and teens ages 19 and younger.

The agency looked at traumatic brain injuries, a category of injuries that mostly counts concussions but also includes skull fractures and bleeding in the brain.

The estimated numbers of kids coming into ERs with these brain injuries rose dramatically, about 153,000 in 2001 to nearly 250,000 in 2009. The rate also rose, also by about 60 percent.

However, there was not a significant increase in the rate of kids who were immediately admitted to the main hospital for further treatment. That suggests that more so than in the past, more coaches and parents have been bringing kids to the ER with mild concussions and blows to the head, said Dr. Julie Gilchrist, a CDC epidemiologist who led the study.

That's probably due to more awareness of the formerly under-appreciated long-term hazards of concussions, she added.

In 2003, the CDC started a "Heads Up" youth concussion awareness campaign targeting doctors. Since then, the agency has expanded the focus to coaches and school officials.

That effort was bolstered by a series of studies that began to appear around 2005 that showed damage in the brains of former National Football League players. Media coverage of such studies has intensified in the past four years, too, with reports focusing not only on football players but also the actress Natasha Richardson, who died in 2009 from a brain injury from a skiing accident.

At the University of Rochester Medical Center in New York state, nearly all of the kids who come in with concussions are brought in by their parents. Such visits have been increasing, and many parents seem to have become aware of the danger of concussions by reports on television, said Dr. Jeffrey Bazarian, an emergency physician there.

"I think the TV specials on this have them spooked," he said.

Parents may also be motivated by recently passed state laws in New York and elsewhere that require student athletes with concussion symptoms to be cleared by a medical professional before being allowed to participate in sports, Bazarian said.

In 2011, bills were introduced in at least 39 states that were aimed at better management of traumatic brain injuries, and most targeted sports-related concussions in youths, according to the National Conference of State Legislatures.

Other highlights from the CDC study:

—About 70 percent of the ER visits were by boys.

—About 70 percent were kids ages 10 to 19.

—Younger kids commonly got their injuries on the playground or from biking. Older kids were more likely to get them from sports, with football being the leading source for brain injuries in older boys, and biking, soccer and basketball for older girls.

—The estimated number of traumatic brain injuries in athletic kids held about steady from 2001 to 2004, but then shot up afterward, rising most dramatically from 2008 to 2009.

—Overall, about 15 percent of such traumatic brain injuries each year was from bicycling, on average, making that the leading cause. Football was a close second.

Health officials have long advocated the use of bicycle helmets as a way to reduce the severity of head injuries, but helmet use dropped after the early 1990s and has been holding at a fairly low rate for more than a decade. About 85 percent of youths say they rarely or never wear a bicycle helmet, according to one government survey.

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Online:

CDC report: http://www.cdc.gov/mmwr