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Master Thesis

Céphalées primaires : facteurs prédictifs d'une nouvelle consultation dans le mois suivant la sortie d'un Service d'Accueil des Urgences

Abstract : Objective. Primary headache disorders are a major public health issue, due to their frequency and their socioeconomic impact. We aimed to identify predictors of poor prognosis after emergency department (ED) discharge for patients suffering from primary headache disorders. Methods. In a prospective cohort study, ambulatory patients admitted to ED for headache were included and phoned 30 days after ED discharge. The first endpoint was a new office visit for headache management in the meantime. The data were collected from an autoquestionnaire and from the ED medical records. Four categories of potential predictors were studied: patient’s characteristics, initial symptoms, ED headache management and perceived quality of headache management. Results. During a four-month period, 126 patients were screened and 40 were included. Twenty-seven (67.5 %) had required a new office visit. Twenty-six (65 %) were female patients, and the average age was 35.9 years old. In the ED, one patient (2.5 %) received a triptan, 5 (12.5 %) received a nonsteroidal anti-inflammatory drug and 12 (30 %) received tramadol. Predictors of a new office visit were initial nausea or vomiting (p = 0.02), intravenous treatment (p = 0.007), prescription of weak opioid drugs at ED discharge (p = 0.03) and female patients (p = 0.03). Conclusion. Several areas for improvement have been identified: improvement of treatment efficiency through the use of specific and suitable analgesics; improvement of diagnostic accuracy via better physician training and establishment of appropriate criteria for ED management; improvement of prognosis through the identification of chronicity factors and the facilitation of the access to specialists.
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Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-01238125
Contributor : Bu Carreire Université de Bordeaux <>
Submitted on : Friday, December 4, 2015 - 12:54:26 PM
Last modification on : Sunday, October 25, 2020 - 7:04:52 AM
Long-term archiving on: : Saturday, April 29, 2017 - 7:09:47 AM

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  • HAL Id : dumas-01238125, version 1

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Renaud Jacquemin. Céphalées primaires : facteurs prédictifs d'une nouvelle consultation dans le mois suivant la sortie d'un Service d'Accueil des Urgences. Médecine humaine et pathologie. 2015. ⟨dumas-01238125⟩

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