Ítem
Acceso Abierto

Headache at the emergency room: Etiologies, diagnostic usefulness of the ICHD 3 criteria, red and green flags

Mostrar el registro sencillo de la publicación
dc.creatorMunoz-Ceron, Joespa
dc.creatorMarin-Careaga, Variniaspa
dc.creatorPeña, Lauraspa
dc.creatorMutis, Jorgespa
dc.creatorOrtiz, Gloriaspa
dc.date.accessioned2020-05-25T23:58:15Z
dc.date.available2020-05-25T23:58:15Z
dc.date.created2019spa
dc.description.abstractIntroduction Non-traumatic headaches account for 0.5 to 4.5% at the emergency department (ED). Although primary headaches represent the most common causes, the likelihood of ominous etiology has to be considered by clinicians in order to avoid diagnostic and therapeutic pitfalls. Due to the absence of biological or imaging findings to diagnose primary headaches we hypothesize ICHD 3(International Headache criteria 3) criteria as a useful tool at the moment to identify and to establish a difference between those patients who are undergoing primary headaches and those who will need advanced diagnostic strategies. Objectives To determine the usefulness of ICHD 3 criteria to differentiate primary from non-primary headaches at the emergency department (ED). Methods During five weeks all the patients complaining of headache attended at the triage unit at the ED were interviewed, examined and classified as having primary or non-primary headaches by means of ICHD 3 criteria. Those patients with primary headaches were treated according to standard of care protocols and followed up by means of phone call communication after 48 hours to assure satisfactory outcome. Those patients classified as having non-primary headaches (secondary headaches and neuralgias) were admitted for additional diagnostic and therapeutic interventions. Between both groups we compared the prevalence of fulfilled criteria for primary headaches and the proportion of traditional red flags such as age, sleep headache onset, associated symptoms, abnormal neurological exam, sudden onset, and nonresponse to analgesics in addition to previous consultation before this evaluation. Results Headache was responsible for 244 (2.3%) out of 10450 admissions at the ED, 77.8% were females. Primary, non-primary (secondary plus neuralgias) and unclassified headaches were 59.4%, 32% and 8.6% respectively. Migraine and cervical myofascial pain were the most frequent etiologies for primary and non-primary causes respectively. Factors associated to non-primary etiologies were immunosuppression (OR: 2.7 IC 95% 2.3–3.3) and age older than 50 (OR: 2.7 IC 95% 2.01–3.62). Abnormal neurological exam, sudden and sleep headache onset were not statistically significant. Factors found to be associated with primary headaches were: fulfilling ICHD 3 criteria (OR: 18.7, IC95% 7.1–48.6), history of migraine (OR: 2.9 IC 95% 2.1–3.9), and history of similar episodes (OR: 2.7 IC 95% 2.3–3.3). Conclusion This data suggests that fulfilling ICHD 3 criteria could be useful to differentiate primary from non-primary headaches. This observation is also valid for immunosuppression, age older than 50, history of migraine and history of similar episodes. © 2019 Munoz-Ceron et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.eng
dc.format.mimetypeapplication/pdf
dc.identifier.doihttps://doi.org/10.1371/journal.pone.0208728
dc.identifier.issn19326203
dc.identifier.urihttps://repository.urosario.edu.co/handle/10336/22828
dc.language.isoengspa
dc.publisherPublic Library of Sciencespa
dc.relation.citationIssueNo. 1
dc.relation.citationTitlePLoS ONE
dc.relation.citationVolumeVol. 14
dc.relation.ispartofPLoS ONE, ISSN:19326203, Vol.14, No.1 (2019)spa
dc.relation.urihttps://www.scopus.com/inward/record.uri?eid=2-s2.0-85059651502&doi=10.1371%2fjournal.pone.0208728&partnerID=40&md5=a09ec5d1e89cf51bc5c82b93c9c8541cspa
dc.rights.accesRightsinfo:eu-repo/semantics/openAccess
dc.rights.accesoAbierto (Texto Completo)spa
dc.source.instnameinstname:Universidad del Rosariospa
dc.source.reponamereponame:Repositorio Institucional EdocURspa
dc.subject.keywordAnalgesic agentspa
dc.subject.keywordAdultspa
dc.subject.keywordAgespa
dc.subject.keywordAnamnesisspa
dc.subject.keywordArticlespa
dc.subject.keywordClinical assessment toolspa
dc.subject.keywordClinical examinationspa
dc.subject.keywordClinical outcomespa
dc.subject.keywordClinical protocolspa
dc.subject.keywordDiagnostic procedurespa
dc.subject.keywordDisease associationspa
dc.subject.keywordDisease classificationspa
dc.subject.keywordDisease coursespa
dc.subject.keywordDrug responsespa
dc.subject.keywordEmergency health servicespa
dc.subject.keywordEmergency wardspa
dc.subject.keywordFemalespa
dc.subject.keywordFollow upspa
dc.subject.keywordHeadachespa
dc.subject.keywordHospital admissionspa
dc.subject.keywordHumanspa
dc.subject.keywordInternational classification of headache disorder third editionspa
dc.subject.keywordMajor clinical studyspa
dc.subject.keywordMalespa
dc.subject.keywordNeuralgiaspa
dc.subject.keywordNeurologic disease assessmentspa
dc.subject.keywordNeurologic examinationspa
dc.subject.keywordPatient carespa
dc.subject.keywordPrevalencespa
dc.subject.keywordPrimary headachespa
dc.subject.keywordSleep headachespa
dc.subject.keywordSymptomatologyspa
dc.subject.keywordTeleconsultationspa
dc.subject.keywordAdolescentspa
dc.subject.keywordHeadachespa
dc.subject.keywordHospital emergency servicespa
dc.subject.keywordImmunosuppressive treatmentspa
dc.subject.keywordInternational classification of diseasesspa
dc.subject.keywordMiddle agedspa
dc.subject.keywordMigrainespa
dc.subject.keywordPhysiologyspa
dc.subject.keywordSleepspa
dc.subject.keywordYoung adultspa
dc.subject.keywordAdolescentspa
dc.subject.keywordAdultspa
dc.subject.keywordEmergency serviceeng
dc.subject.keywordFemalespa
dc.subject.keywordHeadachespa
dc.subject.keywordHumansspa
dc.subject.keywordImmunosuppressionspa
dc.subject.keywordInternational classification of diseasesspa
dc.subject.keywordMalespa
dc.subject.keywordMiddle agedspa
dc.subject.keywordMigraine disordersspa
dc.subject.keywordSleepspa
dc.subject.keywordYoung adultspa
dc.titleHeadache at the emergency room: Etiologies, diagnostic usefulness of the ICHD 3 criteria, red and green flagsspa
dc.typearticleeng
dc.type.hasVersioninfo:eu-repo/semantics/publishedVersion
dc.type.spaArtículospa
Archivos
Bloque original
Mostrando1 - 1 de 1
Miniatura
Nombre:
journal-pone-0208728.pdf
Tamaño:
426.84 KB
Formato:
Adobe Portable Document Format
Descripción:
Descargar
Colecciones
Artículos