Incidence of alarm criteria and attitude towards patients with headache attended in emergency departments

• Published in: Revista de neurologiá Vol. 68; no. 11; pp. 453 - 458
• Main Authors: Vidal-Castello, M, Olivart-Parejo, M, Abadias-Medrano, M J, Purroy, F
• Format: Journal Article
• Language: Spanish
• Published: Spain 01.06.2019
• DOI: 10.33588/rn.6811.2018382

Alarm criteria make it possible to identify persons who visit emergency services because of severe secondary headaches. To determine the socio-demographic characteristics of the patients who visit emergency departments due to headache, the incidence of alarm criteria, treatment and the diagnosis after one year's follow-up. We conducted a retrospective observational cross-sectional study of the persons attended in the emergency department of the Arnau de Vilanova Hospital between June 2014 and May 2015 due to headache. A total of 303 persons were identified, of whom 165 were finally included in the study. There was a predominance of women (66.7%). The mean age was 41.2 ± 15.9 years. Only 16.4% were referred from primary care and 52 (31.5%) presented alarm criteria. A computerised tomography head scan was performed in half of these cases, and lumbar puncture was carried out in four of them (7.7%). A serious cause of headache was found in four cases (2.4%). After one year of follow-up, three patients who did not initially visit because of alarm criteria were diagnosed with severe diseases of the central nervous system, and 23 (13.9%) returned to the emergency department for the same reason. Only one out of every two patients meets the alarm criteria. The proportion of severe secondary headache is really low. The multidisciplinary management of headache needs to be improved in our setting to prevent people visiting the emergency department due to primary headaches without any alarm criteria.