Headache in United States Emergency Departments

Cephalalgia - Tập 26 Số 6 - Trang 684-690 - 2006
JN Goldstein1, Carlos A. Camargo2, AJ Pelletier2, JA Edlow3
1Department of Emergency Medicine, Brigham & Women's Hospital, Boston, MA, USA
2Departments of Emergency Medicine, Massachusetts General Hospital
3Beth Israel Deaconess Medical Center, Boston, MA, USA.

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.

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Cephalalgia

Tập 26 Số 6

684-690

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