Concussions In The Pediatric Population: Patient Loss To Follow-Up At A Safety-Net Hospital

Introduction-Objective: Concussions are a common, comorbid pediatric injury. However, many aspects regarding long-term management still need to be determined. This study aims to identify specific factors in the pediatric population that may be associated with losing follow-up before post-concussion clearance. Methods: We conducted a single-center retrospective study. Data was collected from the medical records of 241 patients seen at the concussion clinic with a primary concern of concussion or post-concussion symptoms. We grouped patients into those receiving full clearance and those lost to follow-up. Clinical and demographic characteristics were compared by group. We conducted binary logistic regression and subsequent multivariate logistic regressions to model variables influencing loss to follow-up. Results: Sixty percent of patients were lost to follow-up. The most common clinical severity risk factor was confusion (32.2%), followed by loss of consciousness (30.6%). In the univariate model, living with at least one biological parent and involvement in sports were significant protective factors against loss of follow-up (OR= 0.131, 95% CI = 0.029-0.597 and OR = 0.477, 95% CI = 0.243-0.937, respectively). Both features significantly reduced the risk of follow-up loss in the multivariate analysis. Older age (>10 years) and fewer appointments (<2) were associated with loss of follow-up (OR = 14.323, 95% CI = 2.947-69.614, and (OR = 20.726, 95% CI = 5.468-78.557, respectively) in the multivariate level. Conclusions: Living with at least one biological parent and involvement in sports were associated with full clearance. Conversely, older age was the most prominent risk factor for loss to follow-up.