Headache in United States Emergency Departments
Tóm tắt
Headache is a common complaint in the emergency department (ED). In order to examine headache work-ups and diagnoses across the USA, we queried a representative sample of adult ED visits (the National Hospital Ambulatory Medical Care Survey) for the years 1992–2001. Headache accounted for 2.1 million ED visits per year (2.2% of visits). Of the 14% of patients who underwent neuroimaging, 5.5% received a pathological diagnosis. Of the 2% of patients who underwent lumbar puncture, 11% received a pathological diagnosis. On multivariable analysis, a decreased rate of imaging was noted for patients without private insurance [odds ratio (OR) 0.61, confidence interval (CI) 0.44, 0.86] and for those presenting off-hours (OR 0.55, CI 0.39, 0.77). Patients over 50 were more likely to receive a pathological diagnosis (OR 3.3, CI 1.2, 9.3). In conclusion, clinicians should ensure that appropriate work-ups are performed regardless of presentation time or insurance status, and be vigilant in the evaluation of older patients.
Từ khóa
Tài liệu tham khảo
1989, Ann Emerg Med, 18, 720
Dalessio DJ, 1994, Neurology, 44, S6
Meuhlig WA, 1975, J Emerg Nurs, 1, 33
Morgenstern LB, 1998, Ann Emerg Med, 32, 297
McCaig LF, 1994, Adv Data, 245, 1
McCaig LF, 1994, Vital Health Stat 1, 34, 1
McCaig LF, 1997, Adv Data, 293, 1
McCaig LF, 2000, Adv Data, 313, 1
McCaig LF, 2001, Adv Data, 320, 1
McCaig LF, 2003, Adv Data, 335, 1
Stussman BJ, 1996, Adv Data, 271, 1
Stussman BJ, 1996, Adv Data, 275, 1
Stussman BJ, 1997, Adv Data, 285, 1
Nourjah P, 1999, Adv Data, 304, 1
Schneider D, 1979, Vital Health Stat 2, 78, i
Census Bureau US.http://www.census.gov(accessed 1 June 2005).