Exploring Age and Sex Patterns for Rehabilitation Referrals After a Concussion: A Retrospective Analysis.
Douglas N Martini, Jennifer Wilhelm, Lindsey Lee and 4 others
PMID 35756984WHAT IT FOUND
Where a patient enters care after concussion strongly predicted referral to therapy.
Sports medicine clinics issued 78.6% of all referrals, while only 7% of patients entering elsewhere received one. Women and those with preexisting comorbidities were also more likely to be referred.
Key findings
01Point of entry was the strongest predictor of referral, with sports medicine clinics responsible for 78.6% of all rehabilitation referrals.
02Female sex and preexisting comorbidities were independently associated with higher odds of receiving a rehabilitation referral.
03Age alone did not significantly predict whether a patient received a rehabilitation referral.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs
Read the rest of this summary
You get three full summaries a month, free, and we do not ask for a card. Search, the TL;DRs and your library stay unlimited either way.
What it does not show
The study was retrospective and relied on electronic health record data, which meant information about the specific mechanism of injury, date of concussion, and symptom severity could not be extracted. The data did not account for socioeconomic factors such as insurance status or finances, which could heavily influence a patient's point of entry and ability to access care. The results are specific to one level 1 trauma center and its satellite units in Oregon, so they may not apply to other geographic areas or healthcare systems. The study could not distinguish between elite and non-elite athletes, or military personnel, limiting the interpretation of which specific subgroups were driving the high referral rates in sports medicine. Variability in how clinicians coded concussions using ICD-10 codes may have resulted in some eligible patients being missed from the dataset.
Declared interests
The authors declared no conflicts of interest. The study was approved by the Oregon Health Science University Institutional Review Board.
The easy way to misread this
Do not interpret the high referral rate in sports medicine as evidence that those patients have more severe injuries. The paper notes that established guidelines for student athletes likely drive these referrals, whereas older adults or non-athletes entering through other channels face significant barriers to care and are referred far less often.