Emergency department headache admissions in an acute care hospital:why do they occur and what can we do about it?
Annals of the Academy of Medicine, Singapore
;
: 1007-1010, 2009.
Artigo
em Inglês
| WPRIM
| ID: wpr-253666
ABSTRACT
<p><b>INTRODUCTION</b>Many patients present to the Emergency Department (ED) complaining of headache and a significant proportion of these visits would result in hospital admissions. This study analyses the demographics, presentation, work-up, reasons for admission, diagnoses and outcomes of patients admitted with the chief complaint of headache--to identify possible ways of reducing such admissions.</p><p><b>MATERIALS AND METHODS</b>A retrospective analysis was done of the electronic medical records/discharge summaries of all adult patients admitted during a 1-year period from January to December 2006 with the diagnosis of primary headaches or secondary headaches not related to trauma, intracranial infection, inflammation, mass lesion, raised intracranial pressure or a serious systemic illness from the ED of the National University Hospital of Singapore.</p><p><b>RESULTS</b>One thousand two hundred and seventy-six patients presented to the adult ED with primary headaches or secondary headaches not related to serious conditions in 2006. This represented 2% of the ED attendances in the period. Two hundred and twenty-three patients were admitted for various reasons--diagnostic uncertainty 110 (49%), pain control 73 (33%), social/patient request 60 (27%) and others 4 (2%). Sixty-six per cent of the patients had either computed tomography (CT) or magnetic resonance (MR) head imaging. Eighteen patients (8%) were eventually diagnosed with a "potentially serious" diagnosis (intracranial haemorrhage, brain metastasis, stroke, meningitis, cerebral inflammation, cysticercosis, cervical osteomyelitis, hydrocephalus, seizure and malignant hypertension).</p><p><b>CONCLUSION</b>Specific strategies addressing the various reasons for admission including physician training, use of evaluation protocols, imaging to exclude secondary pathology, a longer duration of treatment and evaluation in the ED, effective pain control and patient education may help reduce headache admissions.</p>
Texto completo:
DisponíveL
Índice:
WPRIM (Pacífico Ocidental)
Assunto principal:
Admissão do Paciente
/
Singapura
/
Epidemiologia
/
Estudos Retrospectivos
/
Avaliação de Resultados em Cuidados de Saúde
/
Diagnóstico
/
Tratamento Farmacológico
/
Serviço Hospitalar de Emergência
/
Cefaleia
/
Auditoria Médica
Tipo de estudo:
Estudo diagnóstico
/
Guia de Prática Clínica
/
Estudo observacional
Limite:
Humanos
País/Região como assunto:
Ásia
Idioma:
Inglês
Revista:
Annals of the Academy of Medicine, Singapore
Ano de publicação:
2009
Tipo de documento:
Artigo
Similares
MEDLINE
...
LILACS
LIS