Sensitivity of the SNNOOP10 list in the high-risk secondary headache detection.

Autor: García-Azorín D; Headache Unit, Neurology Department, Hospital Clínico Universitario, Valladolid, Spain., Abelaira-Freire J; Emergency Department, Hospital Clínico Universitario San Carlos, Madrid, Spain., González-García N; Headache Unit, Neurology Department, Hospital Clínico Universitario San Carlos, Madrid, Spain., Rodriguez-Adrada E; Emergency Department, Hospital Rey Juan Carlos, Móstoles, Spain., Schytz HW; Danish Headache Center, Department of Neurology, Rigshospitalet-Glostrup, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark., Barloese M; Center for Functional and Diagnostic Imaging and Research, Department of Clinical Physiology and Nuclear Medicine, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark., Guerrero ÁL; Headache Unit, Neurology Department, Hospital Clínico Universitario, Valladolid, Spain.; Institute of Biomedical Research of Salamanca (Ibsal), Salamanca, Spain., Porta-Etessam J; Neurology Department, Hospital Clínico Universitario San Carlos, Madrid, Spain.; Instituto de Investigación Sanitaria San Carlos (IdISSC), Madrid, Spain., Martín-Sánchez FJ; Emergency Department, Hospital Clínico Universitario San Carlos, Madrid, Spain.; Instituto de Investigación Sanitaria San Carlos (IdISSC), Madrid, Spain.
Jazyk: angličtina
Zdroj: Cephalalgia : an international journal of headache [Cephalalgia] 2022 Dec; Vol. 42 (14), pp. 1521-1531. Date of Electronic Publication: 2022 Aug 24.
DOI: 10.1177/03331024221120249
Abstrakt: Aim: To evaluate the diagnostic accuracy of the SNNOOP10 list in the detection of high-risk headaches.
Methods: Patients that visited the Hospital Clínico San Carlos (Madrid) emergency department due to headache that were allocated to a Manchester Triage System level between critical and urgent were prospectively included but retrospectively analysed. A researcher blind to the patients' diagnosis administered a standardised questionnaire and afterwards a neurologist blind to the questionnaire results diagnosed the patient according to the International Classification of Headache Disorders. The primary endpoint was to assess the sensitivity of the SNNOOP10 list in the detection of high-risk headaches. Secondary endpoints included the evaluation of the sensitivity, specificity, positive predictive value, negative predictive value and area under the curve of each SNNOOP10 item.
Results: Between April 2015 and October 2021, 100 patients were included. Patients were 44 years old (inter-quartile range: 33.6-64.7) and 57% were female. We identified 37 different diagnoses. Final diagnosis was a primary headache in 33%, secondary headache in 65% and cranial neuralgia in 2%. There were 46 patients that were considered as having high-risk headache. Patients from the primary headache group were younger and more frequently female. Sensitivity of SNNOOP10 list was 100% (95% confidence interval: 90.2%-100%). The items with higher sensitivity were neurologic deficit or disfunction (75.5%), pattern change or recent onset of the headache (64.4%), onset after 50 years (64.4%). The most specific items were posttraumatic onset of headache (94.5%), neoplasm in history (89.1%) and systemic symptoms (89%). The area under the curve of the SNNOOP10 list was 0.66 (95% CI: 0.55-0.76).
Conclusion: The red flags from the SNNOOP10 list showed a 100% sensitivity in the detection of high-risk headache disorders.
Databáze: MEDLINE
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