Study about the Manchester Triage System subtriage in patients that visited the Emergency Department due to headache.

Autor:	García-Azorín D; Unidad de Cefaleas, Servicio de Neurología, Hospital Clínico Universitario de Valladolid, Valladolid, España; Instituto de Investigación Biomédica de Salamanca (IBSAL), Salamanca, España., Abelaira-Freire J; Servicio de Emergencias, Hospital Clínico Universitario San Carlos, Madrid, España., Rodriguez-Adrada E; Servicio de Emergencias, Hospital Rey Juan Carlos, Madrid, España., González-García N; Unidad de Cefaleas, Servicio de Neurología, Hospital Clínico Universitario San Carlos, Madrid, España., Guerrero ÁL; Unidad de Cefaleas, Servicio de Neurología, Hospital Clínico Universitario de Valladolid, Valladolid, España; Instituto de Investigación Biomédica de Salamanca (IBSAL), Salamanca, España; Departamento de Medicina, Facultad de Medicina, Universidad de Valladolid, Valladolid, España., Porta-Etessam J; Unidad de Cefaleas, Servicio de Neurología, Hospital Clínico Universitario San Carlos, Madrid, España; Instituto de Investigación Sanitaria San Carlos (IdISSC), Madrid, España. Electronic address: jporta@yahoo.com., Martín-Sánchez FJ; Servicio de Emergencias, Hospital Clínico Universitario San Carlos, Madrid, España; Departamento de Medicina, Facultad de Medicina, Universidad Complutense de Madrid, Madrid, España; Instituto de Investigación Sanitaria San Carlos (IdISSC), Madrid, España.
Jazyk:	English; Spanish; Castilian
Zdroj:	Neurologia [Neurologia (Engl Ed)] 2020 Oct 22. Date of Electronic Publication: 2020 Oct 22.
DOI:	10.1016/j.nrl.2020.06.019
Abstrakt:	Introduction: Headache is a frequent cause of consultation; it is important to detect patients with secondary headache, particularly high-risk secondary headache. Such systems as the Manchester Triage System (MTS) are used for this purpose. This study aims to evaluate the frequency of sub-triage in patients attending the Emergency Department due to headache. Material and Methods: We studied a series of consecutive patients who came to the Emergency Department with headache and presenting some warning sign, defined as the presence of signs leading the physician to request an emergency neuroimaging study and/or assessment by the on-call neurologist. The reference diagnosis was established by neurologists. We evaluated the MTS triage level assigned and the presence of warning signs that may imply a higher level than that assigned. Results: We registered a total of 1,120 emergency department visits due to headache, and 248 patients (22.8%) were eligible for study inclusion. Secondary headache was diagnosed in 126 cases (50.8% of the sample; 11.2% of the total), with 60 cases presenting high-risk secondary headache (24.2%; 5.4%). According to the MTS, two patients were classified as immediate (0.8%), 26 as very urgent (10.5%), 147 as urgent (59.3%), 68 as normal (27.4%), and five as not urgent (2%). The percentage of patients under-triaged was 85.1% in the very urgent classification level and 23.3% in the urgent level. Conclusion: During the study period, at least one in 10 patients attending the Emergency Department due to headache had secondary headache; one in 20 had high-risk secondary headache. The MTS under-triaged most patients with warning signs suggesting a potential emergency. (Copyright © 2020 Sociedad Española de Neurología. Publicado por Elsevier España, S.L.U. All rights reserved.)
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu