Yamaguchi Hiroshi, Nozu Kandai, Ishiko Shinya, Nagase Hiroaki, Ninchoji Takeshi, Nagano China, Takeda Hiroki, Unzaki Ai, Ishibashi Kazuto, Morioka Ichiro, Iijima Kazumoto, Ishida Akihito
Department of Pediatrics, Kobe University Graduate School of Medicine, Kobe, Hyogo, Japan
Department of Pediatrics, Kobe University Graduate School of Medicine, Kobe, Hyogo, Japan.
BMJ Open. 2021 Apr 12;11(4):e046520. doi: 10.1136/bmjopen-2020-046520.
To examine the association between the number of visits to the emergency department (ED) by children for night-time headaches and exposure to multifaceted factors, such as meteorological conditions and air pollution.
We conducted a clinical observational time-series analysis study.
We reviewed consecutive patients younger than 16 years of age at the primary ED centre in Kobe city, Japan, during the night shift (19:30-7:00 hours) between 1 January 2011 and 31 December 2019.
In total, 265 191 children visited the ED; 822 presented with headache during the study period.
We investigated the effects of meteorological factors and air pollutants by multivariate analysis of Poisson regression estimates. A subanalysis included the relationship between the number of patients with night-time headaches and the above factors by sex. Furthermore, the effect of typhoon landing on patient visits for headache was also analysed. Headache was not classified because examinations were performed by general paediatricians (non-specialists).
The number of patients with night-time headaches displayed distinct seasonal changes, with peaks during the summer. Multivariate analysis of Poisson regression estimates revealed a significant positive relationship between the number of patients for headache and mean temperature. Subanalysis by sex indicated a positive relationship between the number of patients with headache and mean temperature in both sexes; however, it was significant only for females. No relationship was found between the number of patients with headache and air pollution. There was no change in the number of patients for night-time headaches 3 days before and after typhoon landing.
High temperature is the main factor for visiting ED for night-time headaches among children in Kobe city. Our results suggest that preventive measures against night-time headaches may be possible by reducing time spent outside during summer.
探讨儿童因夜间头痛前往急诊科（ED）就诊的次数与气象条件和空气污染等多方面因素之间的关联。
我们进行了一项临床观察性时间序列分析研究。
我们回顾了2011年1月1日至2019年12月31日期间日本神户市主要急诊科夜间（19:30 - 7:00）值班时16岁以下的连续患者。
共有265191名儿童前往急诊科就诊；在研究期间，822名儿童出现头痛症状。
我们通过泊松回归估计的多变量分析研究气象因素和空气污染物的影响。一项亚分析包括按性别分析夜间头痛患者数量与上述因素之间的关系。此外，还分析了台风登陆对头痛患者就诊的影响。由于检查由普通儿科医生（非专科医生）进行，头痛未进行分类。
夜间头痛患者数量呈现明显的季节性变化，夏季达到峰值。泊松回归估计的多变量分析显示，头痛患者数量与平均温度之间存在显著正相关。按性别进行的亚分析表明，头痛患者数量与两性的平均温度均呈正相关；然而，仅在女性中具有统计学意义。未发现头痛患者数量与空气污染之间存在关联。台风登陆前后3天，夜间头痛患者数量没有变化。
高温是神户市儿童因夜间头痛前往急诊科就诊的主要因素。我们的结果表明，通过减少夏季户外活动时间，可能有助于预防夜间头痛。
