Martini Douglas N, Wilhelm Jennifer, Lee Lindsey, Brumbach Barbara H, Chesnutt James, Skorseth Paige, King Laurie A
Department of Kinesiology, University of Massachusetts Amherst, Amherst, Massachusetts.
Department of Neurology, Oregon Health & Science University, Portland, Oregon.
Arch Rehabil Res Clin Transl. 2022 Jan 31;4(2):100183. doi: 10.1016/j.arrct.2022.100183. eCollection 2022 Jun.
To explore patterns of postconcussion care at a level 1 trauma center.
Retrospective cohort study.
U.S. level 1 trauma center and local satellite units.
Patients of any age with a concussion diagnosis that reported to level 1 trauma center and local satellite units between 2016 and 2018 (N=2417).
Not applicable.
Age, sex, point of entry, rehabilitation referrals, and pre-existing comorbidity diagnosis.
Patient age (mean [SD]) significantly differed among points of entry, from youngest to oldest: 26.0 (14.0) years in sports medicine, 29.3 (23.0) years in the emergency department, 34.6 (23.6) years at primary care providers, and 46.0 (19.7) years at specialty care departments. Sex also significantly differed among points of entry; emergency departments reported more men (55.6%), whereas the other points of entry reported more women (59.3%-65.6%). Patients were more likely to receive a referral from sports medicine (odds ratio [OR]=75.05, <.001), primary care providers (OR=7.98, <.001), and specialty care departments (OR=7.62, <.001) than from the emergency department. Women were more likely to receive a referral (OR=1.92, <.0001), regardless of point of entry. Lastly, patients with a preexisting comorbidity were more likely (OR=2.12, <.001) to get a rehabilitation referral than patients without a comorbidity.
Point of entry, age, sex, and preexisting comorbidities are associated with postconcussion care rehabilitation referral patterns. Improving concussion education dissemination across all entry points of a level 1 trauma center may standardize the postconcussion rehabilitation referral patterns, potentially improving the time to recovery from a concussion.
探讨一级创伤中心脑震荡后的护理模式。
回顾性队列研究。
美国一级创伤中心及当地卫星单位。
2016年至2018年期间向一级创伤中心及当地卫星单位报告脑震荡诊断的各年龄段患者（N = 2417）。
不适用。
年龄、性别、就诊科室、康复转诊情况及既往合并症诊断。
不同就诊科室患者年龄（均值[标准差]）差异显著，从最年轻到最年长依次为：运动医学科26.0（14.0）岁，急诊科29.3（23.0）岁，初级保健提供者处34.6（23.6）岁，专科护理部门46.0（19.7）岁。不同就诊科室的性别差异也显著；急诊科男性患者比例更高（55.6%），而其他就诊科室女性患者比例更高（59.3% - 65.6%）。与急诊科相比，患者更有可能从运动医学科（优势比[OR] = 75.05，<.001）、初级保健提供者处（OR = 7.98，<.001）和专科护理部门（OR = 7.62，<.001）获得转诊。无论就诊科室如何，女性更有可能获得转诊（OR = 1.92，<.0001）。最后，与无合并症的患者相比，有既往合并症的患者更有可能（OR = 2.12，<.001）获得康复转诊。
就诊科室、年龄、性别和既往合并症与脑震荡后护理康复转诊模式相关。改善一级创伤中心所有就诊点的脑震荡教育传播可能会使脑震荡康复转诊模式标准化，从而有可能缩短脑震荡后的恢复时间。
