Incidence of Alarm Criteria and Attitude Towards Headache Patients Seen in Primary Care

Abstract

Introduction: The alarm criteria make it possible to identify people who consult for severe secondary headaches in the primary care services.
 Objective: To determine the sociodemographic characteristics of patients who come to the emergency room due to headache, the incidence of alarm criteria, treatment and diagnosis after one year of follow-up.
 Patients and methods: Retrospective and observational cross-sectional study of people treated in the primary care of the Arnau de Vilanova Hospital between June 2014 and May 2015 due to headache.
 Results: A total of 303 people were identified, of which 165 were eventually included in the study. There was a predominance of women (66.7%). The mean age was 41.2 ± 15.9 years. Only 16.4% were referred from primary care and 52 (31.5%) had alarm criteria. In half of these cases a cranial computed tomography was performed, and in 4 (7.7%), a lumbar puncture. A serious cause of the headache was identified in 4 cases (2.4%). After one year of follow-up, three patients who initially did not consult due to alarm criteria were diagnosed with serious diseases of the central nervous system, and 23 (13.9%) returned to the emergency room for the same reason.
 Conclusions: Only one out of every two patients meets alarm criteria. The proportion of severe secondary headache is really low. It is necessary to improve the multidisciplinary approach to headache in our setting to avoid consulting for primary headaches without alarm criteria.
 Keywords: sociodemographic.