Morgan, C D; Zuckerman, S L; King, L E; Beaird, S E; Sills, A K; Solomon, G S
Post-concussion syndrome (PCS) in a youth population: defining the diagnostic value and cost-utility of brain imaging Journal Article
In: Child's Nervous System, vol. 31, no. 12, pp. 2305–2309, 2015.
Abstract | Links | BibTeX | Tags: Adolescent, arachnoid cyst, Article, brain, Brain Injury, Child, Computed tomography (CT) neuroimaging, computer assisted tomography, Computer-Assisted, Concussion, cost effectiveness analysis, cost utility analysis, DECISION making, diagnostic value, DSM-IV, Female, human, Humans, image processing, Magnetic Resonance Imaging, Magnetic resonance imaging (MRI), major clinical study, Male, mild traumatic brain injury, neuroimaging, neurosurgery, nuclear magnetic resonance, nuclear magnetic resonance imaging, pathology, Post-Concussion Syndrome, postconcussion syndrome, Preschool, preschool child, priority journal, Radiography, Retrospective Studies, retrospective study, Sports, STATISTICS, Tomography, traumatic brain injury, X ray, X-Ray Computed
@article{Morgan2015,
title = {Post-concussion syndrome (PCS) in a youth population: defining the diagnostic value and cost-utility of brain imaging},
author = {Morgan, C D and Zuckerman, S L and King, L E and Beaird, S E and Sills, A K and Solomon, G S},
doi = {10.1007/s00381-015-2916-y},
year = {2015},
date = {2015-01-01},
journal = {Child's Nervous System},
volume = {31},
number = {12},
pages = {2305--2309},
abstract = {Purpose: Approximately 90% of concussions are transient, with symptoms resolving within 10\textendash14 days. However, a minority of patients remain symptomatic several months post-injury, a condition known as post-concussion syndrome (PCS). The treatment of these patients can be challenging. The goal of our study was to assess the utility and cost-effectiveness of neurologic imaging two or more weeks post-injury in a cohort of youth with PCS. Methods: We conducted a retrospective study of 52 pediatric patients with persistent post-concussion symptoms after 3 months. We collected demographics and neuroimaging results obtained greater than 2 weeks post-concussion. Neuroimaging ordered in the first 2 weeks post-concussion was excluded, except to determine the rate of re-imaging. Descriptive statistics and corresponding cost data were collected. Results: Of 52 patients with PCS, 23/52 (44 %) had neuroimaging at least 2 weeks after the initial injury, for a total of 32 diagnostic studies. In summary, 1/19 MRIs (5.3 %), 1/8 CTs (13 %), and 0/5 x-rays (0 %) yielded significant positive findings, none of which altered clinical management. Chronic phase neuroimaging estimated costs from these 52 pediatric patients totaled $129,025. We estimate the cost to identify a single positive finding was $21,000 for head CT and $104,500 for brain MRI. Conclusions: In this cohort of pediatric PCS patients, brain imaging in the chronic phase (defined as more than 2 weeks after concussion) was pursued in almost half the study sample, had low diagnostic yield, and had poor cost-effectiveness. Based on these results, outpatient management of pediatric patients with long-term post-concussive symptoms should rarely include repeat neuroimaging beyond the acute phase. © 2015, Springer-Verlag Berlin Heidelberg.},
keywords = {Adolescent, arachnoid cyst, Article, brain, Brain Injury, Child, Computed tomography (CT) neuroimaging, computer assisted tomography, Computer-Assisted, Concussion, cost effectiveness analysis, cost utility analysis, DECISION making, diagnostic value, DSM-IV, Female, human, Humans, image processing, Magnetic Resonance Imaging, Magnetic resonance imaging (MRI), major clinical study, Male, mild traumatic brain injury, neuroimaging, neurosurgery, nuclear magnetic resonance, nuclear magnetic resonance imaging, pathology, Post-Concussion Syndrome, postconcussion syndrome, Preschool, preschool child, priority journal, Radiography, Retrospective Studies, retrospective study, Sports, STATISTICS, Tomography, traumatic brain injury, X ray, X-Ray Computed},
pubstate = {published},
tppubtype = {article}
}
Billock, R M; Anderegg, J J; Mehan, T J; Chounthirath, T; Smith, G A
Zipline-related injuries treated in US EDs, 1997-2012 Journal Article
In: American Journal of Emergency Medicine, vol. 33, no. 12, pp. 1745–1749, 2015.
Abstract | Links | BibTeX | Tags: Accidental Falls, Adolescent, adult, arm fracture, Article, body regions, Child, Concussion, emergency health service, Emergency Service, emergency ward, EPIDEMIOLOGY, falling, Female, head and neck injury, head injury, Hospital, hospitalization, human, Humans, Infant, leg injury, major clinical study, Male, Newborn, Preschool, preschool child, priority journal, recreation, residential area, SAFETY, soft tissue injury, sport injury, sprain, statistics and numerical data, trunk injury, UNITED States, Wounds and Injuries, Young Adult, zipline related injury
@article{Billock2015,
title = {Zipline-related injuries treated in US EDs, 1997-2012},
author = {Billock, R M and Anderegg, J J and Mehan, T J and Chounthirath, T and Smith, G A},
doi = {10.1016/j.ajem.2015.08.022},
year = {2015},
date = {2015-01-01},
journal = {American Journal of Emergency Medicine},
volume = {33},
number = {12},
pages = {1745--1749},
abstract = {Purpose To investigate the epidemiology of zipline-related injuries in the United States. Basic Procedures The National Electronic Injury Surveillance System database was used to examine non-fatal zipline-related injuries treated in US emergency departments (EDs) from 1997 through 2012. Sample weights were applied to calculate national estimates. Main Findings From 1997 through 2012, an estimated 16 850 (95% CI, 13 188-20 512) zipline-related injuries were treated in US EDs. The annual injury rate per 1 million population increased by 52.3% from 7.64 (95% CI, 4.86-10.42) injuries in 2009 (the first year with a stable annual estimate) to 11.64 (95% CI, 7.83-15.45) injuries in 2012. Patients aged 0-9 years accounted for 45.0% of injuries, females made up 53.1% of injuries, and 11.7% of patients required hospitalization. Fractures accounted for the largest proportion of injuries (46.7%), and the upper extremities were the most commonly injured body region (44.1%). Falls were the most common mechanism of injury, accounting for 77.3% of injuries. Among cases where the location of the injury event was known, 30.8% of injuries occurred in a residential setting and 69.2% occurred in a public place. Principal Conclusions This study is the first to characterize the epidemiology of zipline-related injuries using a nationally representative database. The rapid increase in zipline-related injuries in recent years suggests the need for additional safety guidelines and regulations. Commercial ziplines and publicly accessible non-commercial ziplines should be subject to uniform safety standards in all states and jurisdictions across the US, and homemade ziplines should not be used. © 2015 Elsevier Inc.},
keywords = {Accidental Falls, Adolescent, adult, arm fracture, Article, body regions, Child, Concussion, emergency health service, Emergency Service, emergency ward, EPIDEMIOLOGY, falling, Female, head and neck injury, head injury, Hospital, hospitalization, human, Humans, Infant, leg injury, major clinical study, Male, Newborn, Preschool, preschool child, priority journal, recreation, residential area, SAFETY, soft tissue injury, sport injury, sprain, statistics and numerical data, trunk injury, UNITED States, Wounds and Injuries, Young Adult, zipline related injury},
pubstate = {published},
tppubtype = {article}
}
Anonymous,
Tackling in youth football Journal Article
In: Pediatrics, vol. 136, no. 5, pp. e1419–e1430, 2015.
Abstract | Links | BibTeX | Tags: Adolescent, ankle injury, athlete, Athletic Injuries, causal attribution, Child, Concussion, contusion, Craniocerebral Trauma, disease association, football, hand injury, head and neck injury, human, Humans, Injuries, injury severity, knee injury, muscle training, Neck Injuries, Neck muscle, nonhuman, Preschool, preschool child, priority journal, protective equipment, quadriplegia, Review, sport injury, standards, strategic planning
@article{Anonymous2015,
title = {Tackling in youth football},
author = {Anonymous},
doi = {10.1542/peds.2015-3282},
year = {2015},
date = {2015-01-01},
journal = {Pediatrics},
volume = {136},
number = {5},
pages = {e1419--e1430},
abstract = {American football remains one of the most popular sports for young athletes. The injuries sustained during football, especially those to the head and neck, have been a topic of intense interest recently in both the public media and medical literature. The recognition of these injuries and the potential for longterm sequelae have led some physicians to call for a reduction in the number of contact practices, a postponement of tackling until a certain age, and even a ban on high school football. This statement reviews the literature regarding injuries in football, particularly those of the head and neck, the relationship between tackling and football-related injuries, and the potential effects of limiting or delaying tackling on injury risk. © 2015 by the American Academy of Pediatrics.},
keywords = {Adolescent, ankle injury, athlete, Athletic Injuries, causal attribution, Child, Concussion, contusion, Craniocerebral Trauma, disease association, football, hand injury, head and neck injury, human, Humans, Injuries, injury severity, knee injury, muscle training, Neck Injuries, Neck muscle, nonhuman, Preschool, preschool child, priority journal, protective equipment, quadriplegia, Review, sport injury, standards, strategic planning},
pubstate = {published},
tppubtype = {article}
}
Morgan, C D; Zuckerman, S L; King, L E; Beaird, S E; Sills, A K; Solomon, G S
Post-concussion syndrome (PCS) in a youth population: defining the diagnostic value and cost-utility of brain imaging Journal Article
In: Child's Nervous System, vol. 31, no. 12, pp. 2305–2309, 2015.
@article{Morgan2015,
title = {Post-concussion syndrome (PCS) in a youth population: defining the diagnostic value and cost-utility of brain imaging},
author = {Morgan, C D and Zuckerman, S L and King, L E and Beaird, S E and Sills, A K and Solomon, G S},
doi = {10.1007/s00381-015-2916-y},
year = {2015},
date = {2015-01-01},
journal = {Child's Nervous System},
volume = {31},
number = {12},
pages = {2305--2309},
abstract = {Purpose: Approximately 90% of concussions are transient, with symptoms resolving within 10\textendash14 days. However, a minority of patients remain symptomatic several months post-injury, a condition known as post-concussion syndrome (PCS). The treatment of these patients can be challenging. The goal of our study was to assess the utility and cost-effectiveness of neurologic imaging two or more weeks post-injury in a cohort of youth with PCS. Methods: We conducted a retrospective study of 52 pediatric patients with persistent post-concussion symptoms after 3 months. We collected demographics and neuroimaging results obtained greater than 2 weeks post-concussion. Neuroimaging ordered in the first 2 weeks post-concussion was excluded, except to determine the rate of re-imaging. Descriptive statistics and corresponding cost data were collected. Results: Of 52 patients with PCS, 23/52 (44 %) had neuroimaging at least 2 weeks after the initial injury, for a total of 32 diagnostic studies. In summary, 1/19 MRIs (5.3 %), 1/8 CTs (13 %), and 0/5 x-rays (0 %) yielded significant positive findings, none of which altered clinical management. Chronic phase neuroimaging estimated costs from these 52 pediatric patients totaled $129,025. We estimate the cost to identify a single positive finding was $21,000 for head CT and $104,500 for brain MRI. Conclusions: In this cohort of pediatric PCS patients, brain imaging in the chronic phase (defined as more than 2 weeks after concussion) was pursued in almost half the study sample, had low diagnostic yield, and had poor cost-effectiveness. Based on these results, outpatient management of pediatric patients with long-term post-concussive symptoms should rarely include repeat neuroimaging beyond the acute phase. © 2015, Springer-Verlag Berlin Heidelberg.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Billock, R M; Anderegg, J J; Mehan, T J; Chounthirath, T; Smith, G A
Zipline-related injuries treated in US EDs, 1997-2012 Journal Article
In: American Journal of Emergency Medicine, vol. 33, no. 12, pp. 1745–1749, 2015.
@article{Billock2015,
title = {Zipline-related injuries treated in US EDs, 1997-2012},
author = {Billock, R M and Anderegg, J J and Mehan, T J and Chounthirath, T and Smith, G A},
doi = {10.1016/j.ajem.2015.08.022},
year = {2015},
date = {2015-01-01},
journal = {American Journal of Emergency Medicine},
volume = {33},
number = {12},
pages = {1745--1749},
abstract = {Purpose To investigate the epidemiology of zipline-related injuries in the United States. Basic Procedures The National Electronic Injury Surveillance System database was used to examine non-fatal zipline-related injuries treated in US emergency departments (EDs) from 1997 through 2012. Sample weights were applied to calculate national estimates. Main Findings From 1997 through 2012, an estimated 16 850 (95% CI, 13 188-20 512) zipline-related injuries were treated in US EDs. The annual injury rate per 1 million population increased by 52.3% from 7.64 (95% CI, 4.86-10.42) injuries in 2009 (the first year with a stable annual estimate) to 11.64 (95% CI, 7.83-15.45) injuries in 2012. Patients aged 0-9 years accounted for 45.0% of injuries, females made up 53.1% of injuries, and 11.7% of patients required hospitalization. Fractures accounted for the largest proportion of injuries (46.7%), and the upper extremities were the most commonly injured body region (44.1%). Falls were the most common mechanism of injury, accounting for 77.3% of injuries. Among cases where the location of the injury event was known, 30.8% of injuries occurred in a residential setting and 69.2% occurred in a public place. Principal Conclusions This study is the first to characterize the epidemiology of zipline-related injuries using a nationally representative database. The rapid increase in zipline-related injuries in recent years suggests the need for additional safety guidelines and regulations. Commercial ziplines and publicly accessible non-commercial ziplines should be subject to uniform safety standards in all states and jurisdictions across the US, and homemade ziplines should not be used. © 2015 Elsevier Inc.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Anonymous,
Tackling in youth football Journal Article
In: Pediatrics, vol. 136, no. 5, pp. e1419–e1430, 2015.
@article{Anonymous2015,
title = {Tackling in youth football},
author = {Anonymous},
doi = {10.1542/peds.2015-3282},
year = {2015},
date = {2015-01-01},
journal = {Pediatrics},
volume = {136},
number = {5},
pages = {e1419--e1430},
abstract = {American football remains one of the most popular sports for young athletes. The injuries sustained during football, especially those to the head and neck, have been a topic of intense interest recently in both the public media and medical literature. The recognition of these injuries and the potential for longterm sequelae have led some physicians to call for a reduction in the number of contact practices, a postponement of tackling until a certain age, and even a ban on high school football. This statement reviews the literature regarding injuries in football, particularly those of the head and neck, the relationship between tackling and football-related injuries, and the potential effects of limiting or delaying tackling on injury risk. © 2015 by the American Academy of Pediatrics.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Morgan, C D; Zuckerman, S L; King, L E; Beaird, S E; Sills, A K; Solomon, G S
Post-concussion syndrome (PCS) in a youth population: defining the diagnostic value and cost-utility of brain imaging Journal Article
In: Child's Nervous System, vol. 31, no. 12, pp. 2305–2309, 2015.
Abstract | Links | BibTeX | Tags: Adolescent, arachnoid cyst, Article, brain, Brain Injury, Child, Computed tomography (CT) neuroimaging, computer assisted tomography, Computer-Assisted, Concussion, cost effectiveness analysis, cost utility analysis, DECISION making, diagnostic value, DSM-IV, Female, human, Humans, image processing, Magnetic Resonance Imaging, Magnetic resonance imaging (MRI), major clinical study, Male, mild traumatic brain injury, neuroimaging, neurosurgery, nuclear magnetic resonance, nuclear magnetic resonance imaging, pathology, Post-Concussion Syndrome, postconcussion syndrome, Preschool, preschool child, priority journal, Radiography, Retrospective Studies, retrospective study, Sports, STATISTICS, Tomography, traumatic brain injury, X ray, X-Ray Computed
@article{Morgan2015,
title = {Post-concussion syndrome (PCS) in a youth population: defining the diagnostic value and cost-utility of brain imaging},
author = {Morgan, C D and Zuckerman, S L and King, L E and Beaird, S E and Sills, A K and Solomon, G S},
doi = {10.1007/s00381-015-2916-y},
year = {2015},
date = {2015-01-01},
journal = {Child's Nervous System},
volume = {31},
number = {12},
pages = {2305--2309},
abstract = {Purpose: Approximately 90% of concussions are transient, with symptoms resolving within 10\textendash14 days. However, a minority of patients remain symptomatic several months post-injury, a condition known as post-concussion syndrome (PCS). The treatment of these patients can be challenging. The goal of our study was to assess the utility and cost-effectiveness of neurologic imaging two or more weeks post-injury in a cohort of youth with PCS. Methods: We conducted a retrospective study of 52 pediatric patients with persistent post-concussion symptoms after 3 months. We collected demographics and neuroimaging results obtained greater than 2 weeks post-concussion. Neuroimaging ordered in the first 2 weeks post-concussion was excluded, except to determine the rate of re-imaging. Descriptive statistics and corresponding cost data were collected. Results: Of 52 patients with PCS, 23/52 (44 %) had neuroimaging at least 2 weeks after the initial injury, for a total of 32 diagnostic studies. In summary, 1/19 MRIs (5.3 %), 1/8 CTs (13 %), and 0/5 x-rays (0 %) yielded significant positive findings, none of which altered clinical management. Chronic phase neuroimaging estimated costs from these 52 pediatric patients totaled $129,025. We estimate the cost to identify a single positive finding was $21,000 for head CT and $104,500 for brain MRI. Conclusions: In this cohort of pediatric PCS patients, brain imaging in the chronic phase (defined as more than 2 weeks after concussion) was pursued in almost half the study sample, had low diagnostic yield, and had poor cost-effectiveness. Based on these results, outpatient management of pediatric patients with long-term post-concussive symptoms should rarely include repeat neuroimaging beyond the acute phase. © 2015, Springer-Verlag Berlin Heidelberg.},
keywords = {Adolescent, arachnoid cyst, Article, brain, Brain Injury, Child, Computed tomography (CT) neuroimaging, computer assisted tomography, Computer-Assisted, Concussion, cost effectiveness analysis, cost utility analysis, DECISION making, diagnostic value, DSM-IV, Female, human, Humans, image processing, Magnetic Resonance Imaging, Magnetic resonance imaging (MRI), major clinical study, Male, mild traumatic brain injury, neuroimaging, neurosurgery, nuclear magnetic resonance, nuclear magnetic resonance imaging, pathology, Post-Concussion Syndrome, postconcussion syndrome, Preschool, preschool child, priority journal, Radiography, Retrospective Studies, retrospective study, Sports, STATISTICS, Tomography, traumatic brain injury, X ray, X-Ray Computed},
pubstate = {published},
tppubtype = {article}
}
Billock, R M; Anderegg, J J; Mehan, T J; Chounthirath, T; Smith, G A
Zipline-related injuries treated in US EDs, 1997-2012 Journal Article
In: American Journal of Emergency Medicine, vol. 33, no. 12, pp. 1745–1749, 2015.
Abstract | Links | BibTeX | Tags: Accidental Falls, Adolescent, adult, arm fracture, Article, body regions, Child, Concussion, emergency health service, Emergency Service, emergency ward, EPIDEMIOLOGY, falling, Female, head and neck injury, head injury, Hospital, hospitalization, human, Humans, Infant, leg injury, major clinical study, Male, Newborn, Preschool, preschool child, priority journal, recreation, residential area, SAFETY, soft tissue injury, sport injury, sprain, statistics and numerical data, trunk injury, UNITED States, Wounds and Injuries, Young Adult, zipline related injury
@article{Billock2015,
title = {Zipline-related injuries treated in US EDs, 1997-2012},
author = {Billock, R M and Anderegg, J J and Mehan, T J and Chounthirath, T and Smith, G A},
doi = {10.1016/j.ajem.2015.08.022},
year = {2015},
date = {2015-01-01},
journal = {American Journal of Emergency Medicine},
volume = {33},
number = {12},
pages = {1745--1749},
abstract = {Purpose To investigate the epidemiology of zipline-related injuries in the United States. Basic Procedures The National Electronic Injury Surveillance System database was used to examine non-fatal zipline-related injuries treated in US emergency departments (EDs) from 1997 through 2012. Sample weights were applied to calculate national estimates. Main Findings From 1997 through 2012, an estimated 16 850 (95% CI, 13 188-20 512) zipline-related injuries were treated in US EDs. The annual injury rate per 1 million population increased by 52.3% from 7.64 (95% CI, 4.86-10.42) injuries in 2009 (the first year with a stable annual estimate) to 11.64 (95% CI, 7.83-15.45) injuries in 2012. Patients aged 0-9 years accounted for 45.0% of injuries, females made up 53.1% of injuries, and 11.7% of patients required hospitalization. Fractures accounted for the largest proportion of injuries (46.7%), and the upper extremities were the most commonly injured body region (44.1%). Falls were the most common mechanism of injury, accounting for 77.3% of injuries. Among cases where the location of the injury event was known, 30.8% of injuries occurred in a residential setting and 69.2% occurred in a public place. Principal Conclusions This study is the first to characterize the epidemiology of zipline-related injuries using a nationally representative database. The rapid increase in zipline-related injuries in recent years suggests the need for additional safety guidelines and regulations. Commercial ziplines and publicly accessible non-commercial ziplines should be subject to uniform safety standards in all states and jurisdictions across the US, and homemade ziplines should not be used. © 2015 Elsevier Inc.},
keywords = {Accidental Falls, Adolescent, adult, arm fracture, Article, body regions, Child, Concussion, emergency health service, Emergency Service, emergency ward, EPIDEMIOLOGY, falling, Female, head and neck injury, head injury, Hospital, hospitalization, human, Humans, Infant, leg injury, major clinical study, Male, Newborn, Preschool, preschool child, priority journal, recreation, residential area, SAFETY, soft tissue injury, sport injury, sprain, statistics and numerical data, trunk injury, UNITED States, Wounds and Injuries, Young Adult, zipline related injury},
pubstate = {published},
tppubtype = {article}
}
Anonymous,
Tackling in youth football Journal Article
In: Pediatrics, vol. 136, no. 5, pp. e1419–e1430, 2015.
Abstract | Links | BibTeX | Tags: Adolescent, ankle injury, athlete, Athletic Injuries, causal attribution, Child, Concussion, contusion, Craniocerebral Trauma, disease association, football, hand injury, head and neck injury, human, Humans, Injuries, injury severity, knee injury, muscle training, Neck Injuries, Neck muscle, nonhuman, Preschool, preschool child, priority journal, protective equipment, quadriplegia, Review, sport injury, standards, strategic planning
@article{Anonymous2015,
title = {Tackling in youth football},
author = {Anonymous},
doi = {10.1542/peds.2015-3282},
year = {2015},
date = {2015-01-01},
journal = {Pediatrics},
volume = {136},
number = {5},
pages = {e1419--e1430},
abstract = {American football remains one of the most popular sports for young athletes. The injuries sustained during football, especially those to the head and neck, have been a topic of intense interest recently in both the public media and medical literature. The recognition of these injuries and the potential for longterm sequelae have led some physicians to call for a reduction in the number of contact practices, a postponement of tackling until a certain age, and even a ban on high school football. This statement reviews the literature regarding injuries in football, particularly those of the head and neck, the relationship between tackling and football-related injuries, and the potential effects of limiting or delaying tackling on injury risk. © 2015 by the American Academy of Pediatrics.},
keywords = {Adolescent, ankle injury, athlete, Athletic Injuries, causal attribution, Child, Concussion, contusion, Craniocerebral Trauma, disease association, football, hand injury, head and neck injury, human, Humans, Injuries, injury severity, knee injury, muscle training, Neck Injuries, Neck muscle, nonhuman, Preschool, preschool child, priority journal, protective equipment, quadriplegia, Review, sport injury, standards, strategic planning},
pubstate = {published},
tppubtype = {article}
}