到美国急诊室就诊的头痛患者:人口统计学资料、病理诊断的建立和发生率

作     者：Goldstein J.N Camargo Jr. C.A Pelletier A.J Edlow J.A 周永 

作者机构：Department of Emergency Medicine Beth Israel Deaconess Medical Center 1 Deaconess Road Boston MA 02215 United States Dr. 

出 版 物：《世界核心医学期刊文摘(神经病学分册)》 (Digest of the World Core Medical Journals.Clinical Neurology)

年 卷 期：2006年第11期

页      面：43-43页

学科分类：1002[医学-临床医学] 100204[医学-神经病学] 10[医学] 

主　　题：头痛患者 病理诊断 急诊室 美国 美利坚合众国 北美洲 

摘      要：Headache is a common complaint in the emergency department (ED). In order to examine headache work-ups and diagnoses across the USA, we queried a representative sample of adult ED visits (the National Hospital Ambulatory Medical Care Survey)for the years 1992-2001. Headache accounted for 2.1 million ED visits per year (2.2%of visits). Of the 14%of patients who underwent neuroimaging, 5.5%received a pathological diagnosis. Of the 2%of patients who underwent lumbar puncture, 11%received a pathological diagnosis. On multivariable analysis, a decreased rate of imaging was noted for patients without private insurance [odds ratio (OR) 0.61, confidence interval (CI) 0.44, 0.86] and for those presenting off-hours (OR 0.55, CI 0.39, 0.77). Patients over 50 were more likely to receive a pathological diagnosis (OR 3.3, CI 1.2, 9.3). In conclusion, clinicians should ensure that appropriate work-ups are performed regardless of presentation time or insurance status, and be vigilant in the evaluation of older patients.