Palmieri A, Mangini S, Salvati P, Celle M E, Di Pietro P
U.O. di Pronto Soccorso Medico e Medicina d'Urgenza, Istituto Giannina Gaslini, Genova.
Pediatr Med Chir. 2008 Sep-Oct;30(5):249-57.
Headache, a very frequent symptom in pediatrics, can severely affect the child and his family's life quality, representing an important reason of access to a Pediatric Emergency Department. From a clinical point of view, it is useful to subdivide headaches in primary and secondary ones. As far as the primary ones are concerned, the common migraine without aura is recognised as the most frequent in the child, while the most recurrent among the second ones are due to infective processes, and they represent 57% of the patients admitted to ED for headache with acute onset.
We analyzed data collected from June 2000 to December 2006, at the Pediatric Emergency Department of Institute "G. Gaslini" Genoa, concerning the admissions of patients with headache, with particular attention to the necessity of coming up with a clinical and diagnostical path.
During the study, there have been 228.255 admissions, 2.214 of which with a diagnosis of discharge from ED of headache (55% males, 45% females). After triage, 14,3% has been evaluated as white code, 74,3% as green one, 10,8% as yellow one and 0,6% as red code. Final outcome of these patients has been hospitalization for 38%, OBI for 8%, home or ambulatory control for 54%.
The accesses to ED for headache are increasing. Better information of the family is needed, with coordination among territorial structures and clinic management in ED.
头痛是儿科常见症状,会严重影响患儿及其家庭的生活质量,是患儿前往儿科急诊科就诊的重要原因。从临床角度来看,将头痛分为原发性和继发性两类很有必要。就原发性头痛而言,无先兆普通偏头痛被认为是儿童中最常见的类型,而继发性头痛中最常见的是感染性疾病导致的,占因急性头痛就诊于急诊科患者的57%。
我们分析了2000年6月至2006年12月在热那亚“G. 加斯利尼”研究所儿科急诊科收集的有关头痛患者入院的数据,特别关注制定临床诊断路径的必要性。
研究期间,共有228255例入院病例,其中2214例出院诊断为头痛(男性占55%,女性占45%)。分诊后,14.3%被评估为白色编码,74.3%为绿色编码,10.8%为黄色编码,0.6%为红色编码。这些患者的最终结局为38%住院治疗,8%门诊观察,54%回家或门诊随访。
因头痛前往急诊科就诊的人数在增加。需要更好地向家庭提供信息,并加强地区机构之间以及急诊科临床管理的协调。