Recognition and diagnosis of concussion is increasing, but current research shows these patients are discharged from the emergency department (ED) with a wide variability of recommendations and instructions.
To assess the adequacy of documentation of discharge instructions given to patients discharged from the ED with concussions.
This was a quality-improvement study conducted at a University-based Level I trauma center. A chart review was performed on all patients discharged with closed head injury or concussion over a 1-year period. Chi-squared measures of association and Fisher's exact test were used to compare the proportion of patients receiving discharge instructions (printed or documented in the chart as discussed by the physician). Multivariable logistic regression was used to assess the relationship between whether the concussion was sport-related in relation to our primary outcomes.
There were 1855 charts that met inclusion criteria. The physician documented discussion of concussion discharge instructions in 41% (95% confidence interval [CI] 39.2-43.7) and printed instructions were given in 71% (95% CI 69.1-73.2). Physicians documented discussion of instructions more often for sport-related vs. non-sport-related concussion (58% vs. 39%, p = 0.008) with an odds ratio (OR) of 2.1 (95% CI 1.6-2.8). Discharge instructions were given more often for sport-related injuries than those without sport-related injuries (85% vs. 69%, p = 0.047), with an OR of 2.2 (95% CI 1.6-3.1). Children were more likely to have had physician-documented discussion of instructions (56%, 95% CI 52.3-59.1 vs. 31%, 95% CI 28.0-33.6), printed discharge instructions (86%, 95% CI 83.2-88.1 vs. 61%, 95% CI 57.6-63.4), and return-to-play precautions given (11.2%, 95% CI 9.2-13.6 vs. 4.5%, 95% CI 3.4-5.9) compared with adults.
Documentation of discharge instructions given to ED patients with concussions was inadequate, overall.
This research output has an Altmetric Attention Score of 16. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 01 December 2021.
All research outputs
#2,903,495
of 34,411,289 outputs
Outputs from Journal of Emergency Medicine
#544
of 4,576 outputs
Outputs of similar age
#46,888
of 477,940 outputs
Outputs of similar age from Journal of Emergency Medicine
#9
of 54 outputs
Altmetric has tracked 34,411,289 research outputs across all sources so far. Compared to these this one has done particularly well and is in the 91st percentile: it's in the top 10% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 4,576 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 11.1. This one has done well, scoring higher than 88% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 477,940 tracked outputs that were published within six weeks on either side of this one in any source. This one has done particularly well, scoring higher than 90% of its contemporaries.
We're also able to compare this research output to 54 others from the same source and published within six weeks on either side of this one. This one has done well, scoring higher than 83% of its contemporaries.
