García-Azorín David, Abelaira-Freire Jaime, Rodriguez-Adrada Esther, González-García Nuria, Planchuelo-Gómez Álvaro, Guerrero Ángel L, Porta-Etessam Jesús, Martín-Sánchez Francisco J
Headache Unit, Neurology Department, Hospital Clínico Universitario, Valladolid, Spain.
Institute for Biomedical Research of Salamanca (IBSAL), Salamanca, Spain.
Expert Rev Neurother. 2021 May;21(5):599-605. doi: 10.1080/14737175.2021.1906222. Epub 2021 Apr 1.
Headache is a leading reason for presentation to the emergency department (ED) with migraine being the most frequently headache. To ensure the adequate staffing of healthcare providers during peak times of headache visits, we analyzed the temporal distribution of emergency department visits in patients presenting with headache and/or migraine. The authors conducted an ecological study, including all consecutive visits to the ED for headache. Patients were classified according to the IHS Classification. We analyzed circadian, circaseptan and circannual patterns for number of visits, comparing migraine patients with other headache patients. There were 2132 ED visits for headache, including primary headache in 1367 (64.1%) cases; migraine in 963 (45.2%); secondary headache in 404 (18.9%); and unspecified headache in 366 (17.1%). The circadian pattern showed peaks around 11:00-13:00 and 17:00-19:00, with visits during the night shift 45% less frequent (p < 0.001). The circaseptan pattern showed a peak on Monday-Tuesday and a low point on Sunday (p < 0.007). The circannual pattern peaked in March and decreased in June. ED visits for headache showed specific circadian, circaseptan and circannual variations. No differences were found in these patterns when comparing migraine patients to other headache patients.
头痛是患者前往急诊科就诊的主要原因，偏头痛是最常见的头痛类型。为确保在头痛就诊高峰期有足够的医护人员，我们分析了因头痛和/或偏头痛就诊的患者在急诊科就诊的时间分布情况。作者进行了一项生态学研究，纳入了所有因头痛连续前往急诊科就诊的患者。患者根据国际头痛协会（IHS）分类进行划分。我们分析了就诊次数的昼夜、一周和年度模式，比较了偏头痛患者与其他头痛患者。因头痛前往急诊科就诊的有2132例，其中原发性头痛1367例（64.1%）；偏头痛963例（45.2%）；继发性头痛404例（18.9%）；未明确的头痛366例（17.1%）。昼夜模式显示在11:00 - 13:00和17:00 - 19:00左右出现高峰，夜班期间的就诊频率低45%（p < 0.001）。一周模式显示在周一至周二出现高峰，在周日出现低点（p < 0.007）。年度模式在3月达到高峰，6月下降。因头痛前往急诊科就诊呈现出特定的昼夜、一周和年度变化。比较偏头痛患者与其他头痛患者时，在这些模式上未发现差异。
