Evaluation of medical management in the treatment of headache in the urgency and emergency room of the Hospital Regional de Barbacena - MG

Abstract

INTRODUCTION: Detailed clinical evaluation should be the basis for the proper management of headaches in emergency rooms, in order to allow adequate diagnosis and treatment. However, this is not usually observed on clinical rounds. OBJECTIVE: To evaluate the management of headache consultations in an emergency rooms. METHODS: This is a cross-section study was performed analyzing data from 1,317 electronic medical records of patients with headache complaints who sought treatment at the Barbacena City Regional Hospital's between January 1, 2017, and June 20, 2019. Medical records were classified according to the International Classification of Headache Disorders (ICHD-3). The data collected were statistically analyzed using chi-square tests. The study considered a p-value≤0.05 to define statistically significant differences. RESULTS: Three medical records were excluded and 1,314 were analyzed. Among the medical records analyzed, 73.21% of initial diagnoses were classified as headache, 16.67% as migraine, and 10.12% as tension-type headache. Headache corresponded to 59.76% of final diagnoses, migraine to 17.95%, and tension-type headache to 8.52%. Regarding the treatment, 43.99% of patients were prescribed opioids for the remaining were prescribed non-opioid medications. CONCLUSION: The study suggests that the management of headaches is inadequate in emergency rooms, probably due to limited knowledge of health professionals about headache. This resulted in a large number of nonspecific diagnoses and inadequate therapeutic approaches.

Keywords

• headache
• headache in urgency care
• opioid analgesics