Headache patients in the emergency department of a Greek tertiary care hospital

Dermitzakis, Emmanouil V.; Georgiadis, Georgios; Rudolf, Jobst; Nikiforidou, Dimitra; Kyriakidis, Panagiotis; Gravas, Ioannis; Bouziani, Chrysanthi; Tsiptsios, Iakovos

doi:10.1007/s10194-009-0178-3

Cited by 22 publications

(21 citation statements)

References 22 publications

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“…The strong association between dyspnoea and hospitalisation and acute morbidity in our study is in line with another study, in which 59% of patients presenting to the ED with dyspnoea were admitted . On the other hand, the low prevalence of acute morbidity in patients with complaints such as chest pain, headache or dizziness is in line with previous studies . About half of the patients presenting with abdominal pain suffered from acute morbidity in our study, which is in line with previous reports .…”

Section: Discussionsupporting

confidence: 93%

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Clinical intuition ratings are associated with morbidity and hospitalisation

et al. 2015

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SummaryObjectiveTo evaluate how the rating of the severity of sickness – as performed by the physician, nurse and patient – is associated with hospitalisation and acute morbidity.MethodsProspective observational study, performed in the emergency department of a tertiary hospital. Patients, physicians and nurses were interviewed separately after the first contact from 21 October through to 11 November 2013.ResultsOf 2426 presenting patients, 1861 were screened, and 1196 were included. A total of 299 (25%) were hospitalised, 504 (42%) suffered acute morbidity. In the univariate analysis, the physician's, nurse's and patient's rating of severity of sickness, expressed on a scale from 0 to 10, was significantly associated with hospitalisation (physicians: OR 1.61, 95% CI 1.50–1.73; nurses: OR 1.52, 1.41–1.64; patients: OR 1.16, 1.10–1.22), and with acute morbidity (OR 1.49, 1.40–1.59; OR 1.39, 1.30–1.48 and OR 1.05, 1.003–1.09 respectively). The area under the curve of the receiver operating characteristic curves was 0.77, 0.72 and 0.61 for hospitalisation, and 0.72, 0.68 and 0.54 for acute morbidity. The interrater reliability was estimated by the intraclass correlation, which was 0.49 for physician/nurse, 0.17 for nurse/patient and 0.07 for physician/patient. In a multivariable analysis model consisting of age, male sex, ethnic origin, ratings of severity of sickness, symptoms, ability to go home and hospitalisation during the preceding 12 months, only age, and the physician's and nurses' rating of severity of sickness remained significantly associated with both outcomes.ConclusionThe first impression of severity of sickness was associated with hospitalisation and morbidity.

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Section: Discussionsupporting

confidence: 93%

“…On the other hand, the low prevalence of acute morbidity in patients with complaints such as chest pain, headache or dizziness is in line with previous studies 4, 22, 23, 24. About half of the patients presenting with abdominal pain suffered from acute morbidity in our study, which is in line with previous reports 5, 25, 26.…”

Section: Discussionsupporting

confidence: 93%

Clinical intuition ratings are associated with morbidity and hospitalisation

et al. 2015

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“…However, other studies from emergency departments and general practice patients revealed higher percentage of secondary headaches ranging from 22.1% to 42% [4], [15], [18], [19]. We speculated that the reason is that physicians from both neurological and emergency department outpatient are trained to recognize headache disorders as diseases that were attributed to some somatic reasons.…”

Section: Discussionmentioning

confidence: 88%

“…Thus, headache patients visiting clinic may show different clinical features and types from those obtained from the general population-based studies. TTH was reported to be the most frequent diagnosis, followed by secondary headache and migraine in the emergent department based on a Greek study [4]. However, in a Hungary study, migraine was the most common headache, while TTH patients reported more severe disability [5].…”

Section: Introductionmentioning

confidence: 98%

Application of ICHD-II Criteria in a Headache Clinic of China

Dong¹,

Di²,

Dai³

et al. 2012

PLoS ONE

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BackgroundChina has the huge map and the largest population in the world. Previous studies on the prevalence and classification of headaches were conducted based on the general population, however, similar studies among the Chinese outpatient population are scarce. This study aimed to analyze the characteristics of 1843 headache patients enrolled in a North China headache clinic of the General Hospital for Chinese People's Liberation Army from October 2011 to May 2012, with the International Classification of Headache Disorders, 2nd Edition (ICHD-II).Methods and ResultsPersonal interviews were carried out and a detailed questionnaire was used to collect medical records including age, sex and headache characteristics. Patients came from 28 regions of China with the median age of 40.9 (9–80) years and the female/male ratio of 1.67/1. The primary headaches (78.4%) were classified as the following: migraine (39.1%), tension-type headache (32.5%), trigeminal autonomic cephalalgias (5.3%) and other primary headache (1.5%). Among the rest patients, 12.9% were secondary headaches, 5.9% were cranial neuralgias and 2.5% were unspecified or not elsewhere classified. Fourteen point nine percent (275/1843) were given an additional diagnosis of chronic daily headache, including medication-overuse headache (MOH, 49.5%), chronic tension-type headache (CTTH, 32.7%) and chronic migraine (CM, 13.5%). The visual analogue scale (VAS) score of TTH with MOH was significantly higher than that of CTTH (6.8±2.0 vs 5.6±2.0, P<0.001). The similar result was also observed in VAS score between migraine with MOH and CM (8.0±1.5 vs 7.0±1.5, P = 0.004). The peak age at onset of TTH for male and female were both in the 3rd decade of life. However, the age distribution at onset of migraine shows an obvious sex difference, i.e. the 2nd decade for females and the 1st decade for males.Conclusions/SignificanceThis study revealed the characteristics of the headache clinic outpatients in a tertiary hospital of North China that migraine is the most common diagnosis. Furthermore, most headaches in this patient population can be classified using ICHD-II criteria.

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“…Patients who consult doctors have different clinical features and the distribution of headache types seen in the clinic differs from population-based studies. A study by an ED in Greece [ 3 ] reported that TTH was the most frequent diagnosis, followed by secondary headache and migraine. In a clinical study from a headache center in east Hungary [ 4 ], migraine was the most common headache, while TTH patients reported more severe disability than migraines.…”

Section: Introductionmentioning

confidence: 99%

Classification and clinical features of headache patients: an outpatient clinic study from China

et al. 2011

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This study aimed to analyze and classify the clinical features of headache in neurological outpatients. A cross-sectional study was conducted consecutively from March to May 2010 for headache among general neurological outpatients attending the First Affiliated Hospital of Chongqing Medical University. Personal interviews were carried out and a questionnaire was used to collect medical records. Diagnosis of headache was according to the International classification of headache disorders, 2nd edition (ICHD-II). Headache patients accounted for 19.5% of the general neurology clinic outpatients. A total of 843 (50.1%) patients were defined as having primary headache, 454 (27%) secondary headache, and 386 (23%) headache not otherwise specified (headache NOS). For primary headache, 401 (23.8%) had migraine, 399 (23.7%) tension-type headache (TTH), 8 (0.5%) cluster headache and 35 (2.1%) other headache types. Overall, migraine patients suffered (1) more severe headache intensity, (2) longer than 6 years of headache history and (3) more common analgesic medications use than TTH ones (p < 0.001).TTH patients had more frequent episodes of headaches than migraine patients, and typically headache frequency exceeded 15 days/month (p < 0.001); 22.8% of primary headache patients were defined as chronic daily headache. Almost 20% of outpatient visits to the general neurology department were of headache patients, predominantly primary headache of migraine and TTH. In outpatient headaches, more attention should be given to headache intensity and duration of headache history for migraine patients, while more attention to headache frequency should be given for the TTH ones.

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Headache patients in the emergency department of a Greek tertiary care hospital

Cited by 22 publications

References 22 publications

Clinical intuition ratings are associated with morbidity and hospitalisation

Clinical intuition ratings are associated with morbidity and hospitalisation

Application of ICHD-II Criteria in a Headache Clinic of China

Classification and clinical features of headache patients: an outpatient clinic study from China

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