Children under 6 years with acute headache in Pediatric Emergency Departments. A 2-year retrospective exploratory multicenter Italian study.
Обработка статьи · этапы, ошибки и управление
Ошибки и ограничения
История · было → стало
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Raucci Umberto, Parisi Pasquale, Ferro Valentina, Margani Erika, Vanacore Nicola, Raieli Vincenzo, Bondone Claudia, Calistri Lucia, Suppiej Agnese, Palmieri Antonella, Cordelli Duccio Maria, Savasta Salvatore, Papa Amanda, Verrotti Alberto, Orsini Alessandro, D'Alonzo Renato, Pavone Piero, Falsaperla Raffaele, Velardita Mario, Nacca Raffaella, Papetti Laura, Rossi Roberta, Gioè Daniela, Malaventura Cristina, Drago Flavia, Morreale Cristina, Rossi Lucia, Foiadelli Thomas, Monticone Sonia, Mazzocchetti Chiara, Bonuccelli Alice, Greco Filippo, Marino Silvia, Monte Gabriele, Versace Antonella, Masi Stefano, Di Nardo Giovanni, Reale Antonino, Villani Alberto, Valeriani Massimiliano
Аннотация
METHODS: We performed a multicenter exploratory retrospective study in Italy from January 2017 to December 2018. Preschoolers with new-onset non-traumatic headache admitted to emergency department were included and were subsequently divided into two groups: hospitalized and discharged. Among hospitalized patients, we investigated the characteristics linked to potentially urgent intracranial conditions.
RESULTS: We included 1455 preschoolers with acute headache. Vomiting, ocular motility disorders, ataxia, presence of neurological symptoms and signs, torticollis and nocturnal awakening were significantly associated to hospitalization. Among the 95 hospitalized patients, 34 (2.3%) had potentially urgent intracranial conditions and more frequently they had neurological symptoms and signs, papilledema, ataxia, cranial nerves paralysis, nocturnal awakening and vomiting. Nevertheless, on multivariable logistic regression analysis, we found that only ataxia and vomiting were associated with potentially urgent intracranial conditions.
CONCLUSION: Our study identified clinical features that should be carefully evaluated in the emergency department in order to obtain a prompt diagnosis and treatment of potentially urgent intracranial conditions. The prevalence of potentially urgent intracranial conditions was low in the emergency department, which may suggest that age under six should not be considered an important risk factor for malignant causes as previously thought.