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 (P = .98). Overall, 20.8% had a head computed tomography (CT), with a reduction in performance between 2007 and 2016 (P < .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.

中文翻译：

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就诊于美国急诊科的头痛儿童和年轻人的就诊率、治疗率和严重神经系统疾病的发生率

客观的：

评估因头痛到急诊科就诊的儿童和年轻人的就诊率、神经影像学、治疗和严重神经系统疾病 (SND)。

方法：

我们对 2002 年至 2017 年期间访问美国急诊科的全国代表性抽样调查进行了横断面研究。我们确定了 ≤ 25 岁以头痛为主诉的患者的遭遇。我们报告了就诊、影像学和治疗的发生率，并报告了伴有严重神经系统疾病诊断的比例。

结果：

在≤25 年的就诊中，2.0% 的主诉是头痛，年就诊率没有变化 ( P = .98)。总体而言，20.8% 的人进行了头部计算机断层扫描 (CT)，2007 年至 2016 年期间表现有所下降 ( P < .01)。四分之一（25.2%，95% 置信区间 [CI] 22.2%-28.3%）服用了麻醉剂，2.5%（95% CI 1.7%-3.2%）患有严重的神经系统疾病。

结论：

总体而言，≤ 25 岁患者中 2.0% 的急诊就诊是头痛，严重神经系统疾病的发生率较低。CT 的使用似乎在下降。