Patients With Migraine Frequently Revisit the Emergency Department for Headache

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“Mitigation of ED revisits for headache could be accomplished by “increasing the availability and access to urgent care appointments or walk-in outpatient appointments, especially during off-hour nigh
“Mitigation of ED revisits for headache could be accomplished by “increasing the availability and access to urgent care appointments or walk-in outpatient appointments, especially during off-hour nigh

More than 25% of patients presenting to the emergency department (ED) for migraine typically require subsequent ED revisits for headache within a 6-month period, according to results from a retrospective study published in Headache.

In this study, investigators sought to determine the frequency of ED revisits of patients presenting to 18 New York City EDs for migraine. A multivariable logistic regression was used to determine correlations between ED revisits and age, gender, and socioeconomic status.

A total of 1052 ED visits for migraine during the first half of 2015 were included in this analysis. After the initial migraine visit, 277 patients (26.3%) revisited the ED for headache less than 6 months later. In addition, a total of 131 patients (12.5%) revisited the same hospital's ED ≥2 more times within the first 6 months of the initial migraine visit.

Approximately 4%, 9%, 27.4%, and 46.2% of ED revisits for headache occurred within 24 hours, 72 hours, 30 days, and 90 days of the first visit for migraine, respectively. The researchers observed no significant correlations between ED revisits and age, gender, or socioeconomic status.

Because the investigators did not evaluate patient data prior to 2015, it is possible that some of the index migraine ED visits were already revisits. Although this may not have affected the results significantly, the investigators note this as a potential limitation. An additional limitation of this study was the analysis of de-identified patient data only, which prevented the investigators from determining whether patients were seen in other EDs beyond the 18 included in the study.

The researchers suggest that mitigation of ED revisits for headache could be accomplished by “increasing the availability and access to urgent care appointments or walk-in outpatient appointments, especially during off-hour nights and weekends.”

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Reference

Minen MT, Boubour A, Wahnich A, Grudzen C, Friedman BW. A retrospective nested cohort study of emergency department revisits for migraine in New York City [published online November 2, 2017]. Headache doi: 10.1111/head.13216

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