Southwell Jessica, Afridi Shazia K
GKT Medical School, King's College London, London, UK.
Department of Neurology, Guy's and St Thomas' NHS Trust, London, UK.
Cephalalgia. 2021 Jul;41(8):905-912. doi: 10.1177/0333102420981734. Epub 2021 Feb 18.
There is a lack of data on the burden of primary headache disorders such as migraine on emergency services. Existing data relies on a coding of "headache", which encompasses both primary and secondary headache of all causes; for example, subarachnoid haemorrhage. Guy's and St Thomas' NHS Trust in London is one of the UK's busiest emergency departments with 150,000 attendances per year. Our aim was to assess the healthcare resource utilisation of primary headaches, in particular migraine, in acute medical services.
We conducted an audit of all adult presentations to the emergency department of Guy's and St Thomas' Hospitals which were coded as "headache" over the first 6 months of 2018. We reviewed the initial diagnosis at presentation and also at discharge, investigations and outcome.
Of 78,273 attendances to the emergency department, there were 976 presentations to the emergency department with "headache" as their primary complaint. "Migraine" was the most frequent of all diagnoses, accounting for 30% of all headache presentations and 25% of headache admissions. We calculated the cost of admitting and investigating migraine as £131,250 over the 6-month period.
Emergency admissions for migraine represent an avoidable cost and burden for both the hospital and the migraineur. This data informs us about the need to develop better care pathways for migraine in the community and to improve headache education for physicians and patients.
关于偏头痛等原发性头痛疾病给急诊服务带来的负担，目前缺乏相关数据。现有数据依赖于对“头痛”的编码，其中涵盖了各种原因导致的原发性和继发性头痛；例如，蛛网膜下腔出血。伦敦盖伊和圣托马斯国民保健服务信托基金是英国最繁忙的急诊科之一，每年有15万人次就诊。我们的目的是评估急性医疗服务中原发性头痛，尤其是偏头痛的医疗资源利用情况。
我们对2018年上半年盖伊和圣托马斯医院急诊科所有编码为“头痛”的成人就诊病例进行了审核。我们回顾了就诊时及出院时的初步诊断、检查和结果。
在急诊科的78273人次就诊中，有976人次以“头痛”为主诉前往急诊科就诊。“偏头痛”是所有诊断中最常见的，占所有头痛就诊病例的30%，占头痛住院病例的25%。我们计算出在这6个月期间，偏头痛的住院和检查费用为131250英镑。
偏头痛的急诊住院对医院和偏头痛患者来说都是一项可避免的费用和负担。这些数据让我们认识到有必要在社区为偏头痛制定更好的护理路径，并改善医生和患者的头痛教育。
