Unscheduled adolescents return to the emergency department following acute concussion.

OBJECTIVE: Emergency department (ED) visits due to concussion have increased over recent years. We aimed to identify variables associated with unscheduled adolescents return to the ED.

METHODS: A retrospective cohort study was conducted. All children aged 11 to 18 years who were admitted to the ED due to concussion between 2011 and 2016 were included. Multivariable logistic regression was performed to identify predictors of ED return.

RESULTS: Overall, 616 adolescents were admitted to the ED due to concussion. Within the first week from discharge, 37/616 (6%) patients returned unscheduled to the ED, 21 (3.4%) during the first 48 hours and 16 (2.6%) during the following 3-7 days. Age, gender, ethnicity, diagnosis of concussion on first visit and length-of-stay in the ED were not associated with unscheduled ED returns. Variables that were independently associated with increased odds for an unscheduled ED return included two or more symptoms of concussion [odds ratio (OR): 2.81; 95% confidence interval (CI): (1.16-6.82)], bicycle or motor vehicle accident (OR: 3.48; 95% CI: 1.29-9.4), and performance of CT scan on first visit (OR: 2.47; 95% CI: 1.12-5.48).

CONCLUSIONS: The findings suggest that certain variables on the first ED visit can predict an unscheduled return visit in adolescents.

ABBREVIATIONS: Emergency department (ED); Length of stay (LOS); computerised tomography (CT).