Little Follow-Up for Many Concussion Patients

Little Follow-Up for Many Concussion Patients

Although millions of Americans suffer concussions each year, many aren't given information about traumatic brain injury or follow-up care, a new study finds.

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"The lack of follow-up after a concussion is concerning because these patients can suffer adverse and debilitating effects for a very long time," said study lead author Seth Seabury.

"Even patients who reported experiencing significant post-concussive symptoms often failed to see a provider. This reflects a lack of awareness, among patients and providers, that their symptoms may be connected to their brain injury," Seabury added.

He's director of a population health initiative at the University of Southern California Schaeffer Center for Health Policy and Economics.

The findings, published online May 25 in JAMA Network Open, are based on a sample of 831 patients who went to a top-level trauma center with a concussion, or mild traumatic brain injury (TBI).

Of those, 47 percent said they were given educational materials about TBI when they were discharged. Forty-four percent said they saw a doctor or other health care professional in the three months after their injury.

Of 28 percent of patients whose CT scans showed they had a brain injury, about 40 percent did not see a health provider three months after discharge, the researchers reported.

In addition, about one-third of the patients had three or more moderate-to-severe concussion symptoms within three months, but only about half of those patients had a follow-up visit, the researchers found.

Although concussions are often labeled mild, that term can be misleading, the researchers pointed out. People can have significant symptoms after a concussion, including migraines, thinking issues, vision loss, memory loss, emotional distress or personality disorders.

Too many patients are being treated as if a concussion is a minor injury, study co-author Dr. Geoffrey Manley said in a journal news release.

"This is a public health crisis that is being overlooked. If physicians did not follow-up on patients in the emergency department with diabetes and heart disease, there would be accusations of malpractice," he said.

Manley is principal investigator of the ongoing Transforming Research and Clinical Knowledge in Traumatic Brain Injury study, or TRACK-TBI.

An estimated 3.2 million to 5.3 million Americans live with long-term health effects from a traumatic brain injury, according to the U.S. Centers for Disease Control and Prevention.

Moreover, TBIs accounted for 2.8 million emergency department visits in the United States in 2013, and more than $76 billion in direct and indirect costs.

"Everyone who falls off their bike, slips off their skateboard or falls down the steps needs to be aware of the potential risks of concussion," Manley said.

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Seabury concluded that "the study shows that we need to give patients and doctors the tools to better identify who should be going in for follow-up care."

More information

To learn more about traumatic brain injury and concussion, visit the U.S. Centers for Disease Control and Prevention.


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