Relevance. Headaches are among the most common causes for emergency department (ED) referrals. The aim of the present study was to analyze and review the costs of the patients who referred to ED due to headache. Materials and methods. This study was conducted prospectively with patients who have referred because of headache between September, 1, 2017 and December, 31, 2017 (3 months. Age, gender, educational status, characteristics, smoking status and alcohol use, comorbidities, predisposing factors, headache characteristics, additional symptoms, physical examination findings, vital parameters, examinations ordered, and cost analysis were performed. The patients were divided into two groups as primary and secondary headache. The differences between Primary headache (PHA) and Secondary headache (CHA) of these data were evaluated. Results. The median age of the patients was 40 (IQR:22) years;67.3% of the patients were female. The rate of the patients with PHA was 73.3% whereas 26.7% of the patients were SHA. The median age of the patients with SHA was detected higher than the patients with PHA (p<0.05). There was not any difference for gender, occupation, and social habits (p>0.05). Coronary artery disease (CAD), malignancy and chronic obstructive pulmonary disease (COPD)/asthma prevalence were significantly higher in patients with SHA (p<0.05). The frequency of PHA after stress, fatigue, insomnia, increased mental activity and intake of certain foods was detected higher (p <0.05). The prevalence of sudden onset was higher in patients with SHA (p<0.05). Location, characteristics, severity, and duration of the pain were detected similar between both groups (p>0.05). It was determined that overall condition was better in patients with PHA, and the rate of head & neck and neurological conditions was detected higher in patients with SHA (p <0.05). Fever and lower saturation levels were significantly higher in patients with SHA (p<0.05). Pathological findings were detected in 50% of hemogram analyses, 66.7% of blood gas analyses, 41.6% of complete blood count analyses, 75% of direct X-rays, 42.8% of CTs, 75% of 4 diffusion MRIs, and 50% of LP analyses. Mean ED cost of patients with PHA was 2.3 USD (IQR: 1.2USD), and mean ED cost of patients with SHA was 13.3 USD (IQR: 17.5 $). ED cost of patients with SHA was significantly higher than those with PHA (p<0.05). Conclusion. It was detected that costs of patients whom SHA was considered are higher than those whom PHA was considered. The most significant cause for this depends on the fact that some symptoms and findings exist both in PHA and SHA. We believe that a comprehensive evaluation of these patients may reduce the number of tests and costs accordingly.
Kaan Çelik1, Cemil Kavalcı2 1 Bolu İzzet Baysal University Faculty of Medicine, Emergency department, Turkey 2 Antalya Training and Research Hospital, Emergency department, Turkey
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