Original ArticleDiagnostic Testing and Treatment of Pediatric Headache in the Emergency Department
Section snippets
Methods
This is a retrospective cross-sectional study using the National Hospital Ambulatory Medical Care Survey (NHAMCS) data from 2005-2009. This study was approved by the Institutional Review Board at Oregon Health and Science University.
The NHAMCS group patients by diagnosis using International Classification of Disease, Ninth Edition codes. We obtained our study population by searching the database for patients with a primary discharge diagnosis of headache or migraine. Our patient population
Results
From 2005-2009, there were 448 ED visits with a primary discharge diagnosis of headache or migraine in patients <18 years old, representing approximately 1.7 million ED visits in the US with a discharge diagnosis of headache or migraine over this time period. The median age was 13.1 years with a female predominance (60%).
Of these 448 ED visits, 95 had a discharge diagnosis of migraine headache, representing a national estimate of 340 000 ED visits. The average age of the migraine cohort was
Discussion
Pediatric headache remains a frequent reason for children to visit an ED, accounting for an annual estimate of >340 000 visits in our cohort. This study describes the ED treatment and diagnostic testing of pediatric headache across the US population.
One interesting finding was the high use of CT in the study population. Recent concern over the effects of ionizing radiation, particularly among children, has been raised.16, 17, 18 More than one-third of our cohort received a CT scan with unclear
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The authors declare no conflicts of interest.