美国急诊部就诊头痛的儿童和青年患者的就诊率、治疗方法和严重神经系统疾病。

Rates of Presentation, Treatments and Serious Neurologic Disorders Among Children and Young Adults Presenting to US Emergency Departments With Headache.

机构信息

Division of Emergency Medicine, 2429Ann & Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.

Division of Pediatric Emergency Medicine, Department of Pediatrics, 6619UPMC Children's Hospital of Pittsburgh, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.

出版信息

J Child Neurol. 2021 May;36(6):475-481. doi: 10.1177/0883073820979137. Epub 2020 Dec 24.

DOI:10.1177/0883073820979137

PMID:33356803

Abstract

OBJECTIVE

To evaluate rates of presentation, neuroimaging, therapies, and serious neurologic disorders (SNDs) among children and young adults presenting to the emergency department with headache.

METHODS

We performed a cross-sectional study of a nationally representative sample survey of visits to US emergency departments between 2002 and 2017. We identified encounters of patients ≤25 years old with chief complaint of headache. We report the rates of presentation, imaging, and treatments and report proportions having concomitant diagnoses of serious neurologic disorders.

RESULTS

Among encounters ≤25 years, 2.0% had a chief complaint of headache, with no change in the yearly rates of encounters ( = .98). Overall, 20.8% had a head computed tomography (CT), with a reduction in performance between 2007 and 2016 ( < .01). One-quarter (25.2%, 95% confidence interval [CI] 22.2%-28.3%) were given narcotics and 2.5% (95% CI 1.7%-3.2%) had serious neurologic disorders.

CONCLUSION

Overall, 2.0% of emergency department encounters among patients ≤25 years were for headache, with low rates of serious neurologic disorders. CT use appeared to be declining.

摘要

目的

评估因头痛到急诊科就诊的儿童和青年患者的就诊率、神经影像学表现、治疗方法和严重神经系统疾病（SND）的发生情况。

方法

我们对 2002 年至 2017 年间美国急诊科就诊的患者进行了一项全国代表性样本调查的横断面研究。我们确定了主诉为头痛且年龄≤25 岁的患者就诊情况。我们报告了就诊率、影像学检查和治疗方法，并报告了同时患有严重神经系统疾病的患者比例。

结果

在≤25 岁的就诊患者中，2.0%的患者主诉为头痛，每年的就诊率没有变化（ =.98）。总的来说，20.8%的患者进行了头部计算机断层扫描（CT）检查，2007 年至 2016 年间的检查率呈下降趋势（ <.01）。四分之一（25.2%，95%置信区间 [CI] 22.2%-28.3%）的患者使用了麻醉性镇痛药，2.5%（95% CI 1.7%-3.2%）的患者患有严重神经系统疾病。