Knox J, Chuni C, Naqvi Z, Crawford P, Waring Ws
Hull York Medical School, York, UK.
Acute Med. 2012;11(3):144-9.
The United Kingdom National Health Service has recently prioritised the need for ambulatory care pathways for acute headache. The present study sought to better characterise patients referred to an Acute Medical Unit so as to inform pathway development. In 2011, York Hospital received 306 referrals due to acute headache, representing 3% of acute medical admissions. Investigations included CT scan (38%), lumbar puncture (38%), and MRI (18%); there were no specialised investigations in 26%, and 18% of patients were discharged on the day of presentation. Subarachnoid haemorrhage occurred in only 4 patients (1%), meningitis in 10 (3%), and intracranial tumour in 5 (2%). The findings indicate that a significant proportion of patients with acute headache could be managed by ambulatory care.
英国国民医疗服务体系最近将急性头痛的门诊护理路径需求列为优先事项。本研究旨在更好地描述转诊至急性内科病房的患者特征，以便为路径开发提供信息。2011年，约克医院因急性头痛收到306例转诊病例，占急性内科住院病例的3%。检查包括CT扫描（38%）、腰椎穿刺（38%）和MRI（18%）；26%的患者未进行专门检查，18%的患者在就诊当天出院。仅4例患者（1%）发生蛛网膜下腔出血，10例（3%）发生脑膜炎，5例（2%）发生颅内肿瘤。研究结果表明，相当一部分急性头痛患者可以通过门诊护理进行管理。
