Abstract
Headache is a common presenting complaint in the Emergency Department. The aim of this study was to delineate the demographic profile of patients presenting a chief complaint of headache and to assess the application of diagnostic algorithms for the management of these patients. We examined patients admitted to the Spedali Civili Hospital ED between January 2005 and December 2009 who complained of headache not related to trauma and all patients hospitalized for headache in Neurological Clinic, from ED, between January 2008 and December 2009. 7495 patients were examined at ED for headaches. 72 % of patients were discharged, 22 % were admitted. From 2005 to 2009, there was a definite decrease in the rate of hospitalization due to headache (15 vs 9.9 % in Department of Neurology and 26 vs 18.9 % in all Departments). Considering the decrease year by year, this reduction was significant from 2007 to 2008, when the algorithms were adopted. The most common diagnosis in the ED was “Non-specific headache” (41 %), followed by “Primary headaches and complications of primary headaches” (20.8 %), “Secondary headaches not associated with risk of serious disease” (20.4 %) and “Secondary headache associated with risk of serious disease” (5 %). Over 2-year period (2008–2009) we found an increase in the diagnosis of “Primary headaches and complications of primary headaches” and “Secondary headaches associated with risk of serious disease” compared with a decrease of “nonspecific headache” and “secondary headaches not associated with risk of serious disease”. The use of the diagnostic algorithms and collaborative network between the ED and the Headache Center can improve the management of patients with headache in ED.
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References
Morgensten LB, Huber JV, Luna-Gonzales H, Saldin KR, Grotta JC, Shaw SG, Knudson L, Frankowski RF (2001) Headache in the emergency department. Headache 41:537–541
McCaig LF, Burt CW (2003) National hospital ambulatory medical care survey: 2001 emergency department summary. Adv Data 4:1–29
Evan RW (2005) Diagnosis of headache and medicolegal aspect. In: Evans RW, Mathew NT (eds) Handbook of heahache, 2 edn. Lippincott Williams & Wilkins, Philadelphia, pp 1–27
Bussone G, Casucci G, Frediani F, Manzoni GC, Bonavita V (2008) Le cefalee: manuale teorico-pratico, p 285
Cortelli P, Cevoli S, Nonino F, Baronciani D, Magrini N, Re G, De Berti G, Manzoni GC, Querzani P, Vandelli A (2004) Multidisciplinary Group for Nontraumatic headache in the Emergency Departement. Evidence-Based Diagnosis of Nontraumatic in the Emergency Department: a Consensus Statement on Four Clinical Scenarios. Headache 44:587–595
Headache Classification Subcommittee of the International Headache Society (2004) The International Classification of Headache Disorders:2nd edn. Cephalalgia 24(Suppl 1):9–160
Barton C (1993) Evaluation and treatment of headache patients in the emergency department: a survey. Headache 34:91–94
Friedman BW, Grosberg BM (2009) Diagnosis and management of the primary headache disorders in the emergency departmen setting. Emerg Med Clin North Am 27:71–87
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We would like to acknowledge the contributions made by Dr. Carlo Concoreggi.
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The authors declare that they have no conflict of interest.
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Appendix: Classes of risk
Appendix: Classes of risk
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Pari, E., Rinaldi, F., Gipponi, S. et al. Management of headache disorders in the Emergency Department setting. Neurol Sci 36, 1153–1160 (2015). https://doi.org/10.1007/s10072-015-2148-7
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DOI: https://doi.org/10.1007/s10072-015-2148-7