Sumatriptan as a First-Line Treatment for Headache in the Pediatric Emergency Department.

Autor: Hauser Chatterjee J; Division of Child Neurology, Department of Neurology, University of Washington School of Medicine and the Seattle Children's Research Institute, Center for Integrative Brain Research, Seattle, Washington. Electronic address: Jessica.HauserChatterjee@seattlechildrens.org., Hartford EA; Department of Pediatric Emergency Medicine, University of Washington, Seattle Children's Hospital, Seattle, Washington., Law E; Department of Anesthesiology & Pain Medicine, University of Washington School of Medicine, Seattle, Washington; Center for Child Health, Behavior & Development, Seattle Children's Research Institute, Seattle, Washington., Barry D; Clinical Analytics, Seattle Children's Hospital, Seattle, Washington., Blume H; Division of Child Neurology, Department of Neurology, University of Washington School of Medicine and the Seattle Children's Research Institute, Center for Integrative Brain Research, Seattle, Washington.
Jazyk: angličtina
Zdroj: Pediatric neurology [Pediatr Neurol] 2023 May; Vol. 142, pp. 68-75. Date of Electronic Publication: 2023 Feb 04.
DOI: 10.1016/j.pediatrneurol.2023.01.016
Abstrakt: Background: Headache is a common presenting condition for patients seen in the pediatric emergency department (ED). Intranasal (IN) sumatriptan is a well-tolerated and safe abortive treatment for migraine headache, but it is infrequently administered in pediatric EDs. In this study we characterize an ED migraine pathway that uses IN sumatriptan as a first-line treatment.
Methods: We performed retrospective chart analysis from a single center, reviewing a cohort of patients treated on an ED migraine pathway between October 2016 and February 2020. We reviewed patient demographics, clinical characteristics, treatment patterns, change in pain scores, sumatriptan prescriptions at discharge, length of stay (LOS), ED charges, and unexpected return visits.
Results: A total of 558 patients (aged six to 21 years, 66% female) were included in this study. Overall, the median pretreatment pain score was 7 (interquartile range [IQR]: 5 to 8) and the median post-treatment pain score was 2 (IQR: 0 to 4). Forty-eight percent of patients received IN sumatriptan in the ED, and 36% of those who received sumatriptan were prescribed oral sumatriptan at discharge. When intravenous (IV) access was obtained for headache management, this was associated with a significantly longer LOS and higher ED charges.
Conclusions: IN sumatriptan shows promise as a feasible and potentially effective first-line treatment for pediatric migraine in the ED that could reduce the need for IV therapies, shorten LOS, and lower ED charges. Further research is needed to determine the efficacy of IN sumatriptan relative to other common first-line therapies used to treat pediatric migraine in the ED.
(Copyright © 2023 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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