UPMC study says greater awareness possibly leads to more ER visits for head trauma

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Greater public awareness is one possible factor that has led to a 30 percent increase in emergency room treatment for head injuries from 2006 to 2010, according to a new study.

Children’s Hospital of Pittsburgh of UPMC funded the study, which is slated to be published in an upcoming issue of the Journal of the American Medical Association. The study relies exclusively on data from the Nationwide Emergency Department Sample, which compiles information from emergency rooms across the country.

With patients under the age of 3 and and over the age of 60 showing the greatest uptick in visits, researchers remain uncertain whether significantly more toddlers and seniors are actually getting injured or whether their increases are due to more cautious parents and relatives.

Jennifer R. Marin, an emergency medicine physician at Children’s Hospital and one of the authors of the study, said that further research needs to be done to determine this.

“Our findings just show this increase,” said Dr. Marin. “We don’t know how much of it is actual patients getting injured.”

Dr. Marin said that 99 percent of the head injuries reported were categorized as “minor,” and that most patients were discharged from the emergency department.

This study does point to some questions about how to treat concussions in the future, said Dr. Marin. “I think the increase suggests that we perhaps need other mechanisms to evaluate these patients. A lot of them don’t necessarily need to be neuroimaged. Could they go to primary care physicians, MedExpress, etc., so they’re not overwhelming emergency departments?”

The complication is that head injuries present a broad and subtle array of symptoms. Some people may get an acute headache from a minor concussion, while another person with a life-threatening injury may only exhibit a change in mood or cognition.

“What’s unfortunate about concussions, specifically, is that the severity of symptoms doesn't correlate with the severity of the injury,” said Dr. Marin.

Some states have adopted bicycle helmet laws for youths and mandated impact testing to better diagnose concussions among youth athletes. But for the most part, neither of those efforts helps small children or senior citizens.

“We do need to target these groups more, but not at the expense of providing that same level of prevention to those other age groups,” said Dr. Marin.

Brett Sholtis: bsholtis@post-gazette.com or 412-263-1581.

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