Clinical predictors of poor 30-day headache outcomes after an emergency department visit for acute post-traumatic headache

Andrew R. Wang, Mark J. Calandra, Benjamin W. Friedman

Research output: Contribution to journalArticlepeer-review

Abstract

Purpose: We investigated clinical risk factors that predict poor 30-day headache outcomes among patients evaluated in the emergency department (ED) for post-traumatic headache (PTH). Methods: This was an analysis of data from a randomized, placebo-controlled study of IV metoclopramide + diphenhydramine for acute PTH. Patients were enrolled during an ED visit and received telephone follow-up with a structured questionnaire 30 days later. The primary outcome was frequency of headaches 30 days after ED discharge. We used multivariable logistic regression models to determine which clinical variables were associated with frequent headaches at 30 days. Results: In total, 160 patients were enrolled in the study. 134 (84%) patients completed the 30-day questionnaire and were included in the analysis, including 90 females and 44 males. 30 patients (22%, 95% CI = 0.16 to 0.30) reported frequent headaches at 30-day follow-up. In the multivariable analysis, female sex (OR = 4.03, 95% CI = 1.23±13.13), patients who blamed themselves for their injury (OR = 0.13, 95% CI = 0.04±0.45), and patients who were unsure if they sustained loss of consciousness during the traumatic incident (OR = 5.63, 95% CI = 1.89±16.78) were found to be associated with poor 30-day outcomes. Medication received in the ED and age were not associated. Conclusions: More than 1 out of five patients treated in the ED for acute PTH experienced frequent headaches 30 days later. Women and patients who were uncertain as to whether they had experienced loss of consciousness were at increased risk of frequent PTH. Blaming oneself for the head trauma was associated with less frequent PTH.

Original languageEnglish (US)
Pages (from-to)158-162
Number of pages5
JournalAmerican Journal of Emergency Medicine
Volume49
DOIs
StatePublished - Nov 2021

Keywords

  • Head trauma
  • Post-traumatic headache
  • Traumatic brain injury

ASJC Scopus subject areas

  • Emergency Medicine

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