THE PREVALENCE OF HEADACHE IN EMERGENCY DEPARTMENT OF UNIVERSITY HOSPITAL
Associate prof. Arunas Sciupokas, Judita Salkauskaitė, Jurate Siliunaitė
Lithuanian University of Health Sciences, Department of Neurology.
Aim: The purpose of this study was to determine the frequency of headache in the ED of university hospital and to classify the importancy of complaint, headache etiology, instrumental methods and consultations of specialists used, discharge outcomes.
Material and Methods: We conducted a cross-sectional 7-day repeated study of all patients. All ED charts were investigated, and the word “headache” or headache equivalent was recorded. Three categories of headache as complaint were defined: a) chief complaint; b) side complaint; c) undifferenciated. As for etiology headache was classified into: a) primary headaches; b) secondary headaches. Pain scales use was rated. The usage of instrumental methods and specialists consultations was calculated. Discharge outcomes were defined either outpatient or inpatient.
Results: Charts from 922 ED visits during double 7-day period were reviewed. Headache was most frequent – 28.8%. Headache as the main complaint was 71.5%, side complaint – 19.1%, undifferentiated – 9.4%. Primary headache were diagnosed at 1.1%, secondary headaches – at 98.9%, and 84.0% of them were traumatic patients. Numeric pain scale use rate was 0.64. Headache patients were discharged as outpatients in 204 (79.7%) cases, 12.9% have been referred to medical wards, 3.9% – to surgery. In 62.8% cases trauma headache patients were consulted by neurologist and in 54.6% cases CT scans were performed.
Conclusions: One quarter of all admissions to ED was related to headache. Almost three quarters of admitted headache patients indicated pain as main complaint. Usually trauma patients have been consulted by neurologist and have had CT scans performed.
Keywords: headache, trauma patients, acute pain.