Abstract：
BACKGROUND: Identifying the cause of headaches in pediatric emergency departments (PEDs) can be challenging due to the lack of comprehensive research. This study aims to identify the frequency, characteristics, and unnecessary diagnostic procedures of patients with headaches in the PED setting.
METHODS: A six-month cross-sectional study was conducted at the PED of Alexandria University Children\'s Hospital, including all children with headaches. Children were classified as having primary headache (PH), secondary benign headache (SBH), and secondary serious headache (SSH) according to predetermined criteria. Logistic regression was employed to analyze the risk factors associated with SSH.
RESULTS: A total of 164 visits to the PED were recorded, out of a total of 22,662 visits, accounting for approximately 0.72% of all visits and 1.17% of the total number of children admitted. PH was the most common cause, accounting for 61.0% of cases, followed by SSH with 24.4%, whereas SBH was the least common with 13.4%. Abnormal neurological examination (odds ratio, 53.752 [1.628 to 1774.442], P = 0.026∗) was found to have a strong and statistically significant association with SSH in the multivariate analysis. Regarding the appropriateness of the investigations conducted, it was found that over half (66.5%) of the cases had unnecessary neuroimaging, with 52% of these cases being children with PH.
CONCLUSIONS: Headaches in children are commonly reported during visits to the PED. PH was the most prevalent, followed by SSH, whereas SBH was the least common. Many of the children received inaccurate first diagnoses and performed unnecessary laboratory tests, neuroimaging, and other tests, mostly electroencephalography.
METHODS: A six-month cross-sectional study was conducted at the PED of Alexandria University Children\'s Hospital, including all children with headaches. Children were classified as having primary headache (PH), secondary benign headache (SBH), and secondary serious headache (SSH) according to predetermined criteria. Logistic regression was employed to analyze the risk factors associated with SSH.
RESULTS: A total of 164 visits to the PED were recorded, out of a total of 22,662 visits, accounting for approximately 0.72% of all visits and 1.17% of the total number of children admitted. PH was the most common cause, accounting for 61.0% of cases, followed by SSH with 24.4%, whereas SBH was the least common with 13.4%. Abnormal neurological examination (odds ratio, 53.752 [1.628 to 1774.442], P = 0.026∗) was found to have a strong and statistically significant association with SSH in the multivariate analysis. Regarding the appropriateness of the investigations conducted, it was found that over half (66.5%) of the cases had unnecessary neuroimaging, with 52% of these cases being children with PH.
CONCLUSIONS: Headaches in children are commonly reported during visits to the PED. PH was the most prevalent, followed by SSH, whereas SBH was the least common. Many of the children received inaccurate first diagnoses and performed unnecessary laboratory tests, neuroimaging, and other tests, mostly electroencephalography.
摘要：
背景：由于缺乏全面的研究，确定儿科急诊科（PEDs）头痛的原因可能具有挑战性。本研究旨在确定频率，特点,以及PED设置中头痛患者的不必要诊断程序。
方法：在亚历山大大学儿童医院的PED进行了为期六个月的横断面研究，包括所有有头痛的孩子.儿童被归类为原发性头痛（PH），继发性良性头痛（SBH），根据预定标准和继发性严重头痛（SSH）。采用Logistic回归分析与SSH相关的危险因素。
结果：共记录了164次PED就诊，在总共22,662次访问中，约占所有访视的0.72％和接纳儿童总数的1.17％。PH是最常见的原因,占病例的61.0%，其次是SSH，占24.4%，而SBH是最不常见的13.4%。神经系统检查异常（比值比，53.752[1.628至1774.442],P=0.026*）在多变量分析中发现与SSH具有很强的统计学意义。关于调查的适当性，发现超过一半(66.5%)的病例有不必要的神经影像学检查，这些病例中有52%是患有PH的儿童。
结论：儿童头痛通常在就诊于PED期间报告。PH是最普遍的，其次是SSH，而SBH是最不常见的。许多儿童接受了不准确的首次诊断，并进行了不必要的实验室检查，神经影像学,和其他测试，主要是脑电图.
方法：在亚历山大大学儿童医院的PED进行了为期六个月的横断面研究，包括所有有头痛的孩子.儿童被归类为原发性头痛（PH），继发性良性头痛（SBH），根据预定标准和继发性严重头痛（SSH）。采用Logistic回归分析与SSH相关的危险因素。
结果：共记录了164次PED就诊，在总共22,662次访问中，约占所有访视的0.72％和接纳儿童总数的1.17％。PH是最常见的原因,占病例的61.0%，其次是SSH，占24.4%，而SBH是最不常见的13.4%。神经系统检查异常（比值比，53.752[1.628至1774.442],P=0.026*）在多变量分析中发现与SSH具有很强的统计学意义。关于调查的适当性，发现超过一半(66.5%)的病例有不必要的神经影像学检查，这些病例中有52%是患有PH的儿童。
结论：儿童头痛通常在就诊于PED期间报告。PH是最普遍的，其次是SSH，而SBH是最不常见的。许多儿童接受了不准确的首次诊断，并进行了不必要的实验室检查，神经影像学,和其他测试，主要是脑电图.
