A retrospective analysis of concussion and post-concussional syndrome diagnoses in Western Australian emergency departments

Abstract

Objective(s)To determine the rate of concussion diagnoses per capita recorded in hospital emergency departments in Western Australia (WA) from 2002–2018 for ICD-10-AM concussion diagnoses S06.00-S06.05, and post-concussional syndrome (PCS) (F07.2). Design, setting and analysisRetrospective analysis of hospital Emergency Department (ED) presentations and hospital admissions from all WA hospitals for all patients with an ICD-10-AM diagnosis code for concussion and post-concussional syndrome (PCS) over the period 2002–2018. Data pertaining to concussion and PCS presentations were extracted from the WA Department of Health Emergency Department Data Collection (EDDC). Total case numbers were aggregated by year (2002–2018) and regions of WA. Main outcome measuresThe rates of diagnoses were calculated based on the population in the specific region and expressed as incidence rate per 100,000 person-years. The overall trends of diagnoses across the regions were analysed using negative binomial regression models and expressed as incidence rate ratio (IRR) with the corresponding 95 % CI, whilst adjusting for region. Tests for linearity were also performed. ResultsThe rate of concussion diagnosis had significantly increased linearly over the years (p for trend: p < 0.001) whilst the rate of PCS diagnosis had significantly declined linearly over the same period (p for trend: p < 0.001). ConclusionThere was significant increase in all-cause ICD-10-AM concussion diagnoses in WA emergency departments. To further clarify the incidence and prevalence of all-cause concussion in Australia, investigation must focus on truly reflective S06.0 codes and include data linkage to primary care data. Conversely PCS ED presentations reduced; whether this relates to a change in where presentations occur for management of such a diagnosis, improved early intervention or an alternative explanation warrants further investigation.