Characteristics of men and women with medically diagnosed cluster headache in a national integrated healthcare system: A Veterans Health Administration cohort study.

Autor: Seng EK; Veterans Affairs Headache Centers of Excellence Research, Education, Evaluation, Engagement Center Activities Center for Headache (RE3ACH), West Haven, Connecticut, USA.; Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, New York, USA.; Saul R. Korey Department Neurology, Albert Einstein College of Medicine, Bronx, New York, USA.; Montefiore Medical Center, Bronx, New York, USA., Burish MJ; UT Health Houston, Houston, Texas, USA., Fenton BT; Veterans Affairs Headache Centers of Excellence Research, Education, Evaluation, Engagement Center Activities Center for Headache (RE3ACH), West Haven, Connecticut, USA.; Department of Neurology, Yale University School of Medicine, New Haven, Connecticut, USA.; Yale School of Public Health, New Haven, Connecticut, USA., Schindler EAD; Veterans Affairs Headache Centers of Excellence Research, Education, Evaluation, Engagement Center Activities Center for Headache (RE3ACH), West Haven, Connecticut, USA.; Department of Neurology, Yale University School of Medicine, New Haven, Connecticut, USA., Zhou B; Veterans Affairs Headache Centers of Excellence Research, Education, Evaluation, Engagement Center Activities Center for Headache (RE3ACH), West Haven, Connecticut, USA.; Yale School of Public Health, New Haven, Connecticut, USA., Phadke MA; Veterans Affairs Headache Centers of Excellence Research, Education, Evaluation, Engagement Center Activities Center for Headache (RE3ACH), West Haven, Connecticut, USA.; Yale School of Public Health, New Haven, Connecticut, USA., Skanderson M; Veterans Affairs Headache Centers of Excellence Research, Education, Evaluation, Engagement Center Activities Center for Headache (RE3ACH), West Haven, Connecticut, USA.; Yale School of Public Health, New Haven, Connecticut, USA., Best R; Veterans Affairs Headache Centers of Excellence Research, Education, Evaluation, Engagement Center Activities Center for Headache (RE3ACH), West Haven, Connecticut, USA.; Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, New York, USA., Lipton RB; Saul R. Korey Department Neurology, Albert Einstein College of Medicine, Bronx, New York, USA.; Montefiore Medical Center, Bronx, New York, USA., Sico JJ; Veterans Affairs Headache Centers of Excellence Research, Education, Evaluation, Engagement Center Activities Center for Headache (RE3ACH), West Haven, Connecticut, USA.; Department of Neurology, Yale University School of Medicine, New Haven, Connecticut, USA.
Jazyk: angličtina
Zdroj: Headache [Headache] 2024 Nov-Dec; Vol. 64 (10), pp. 1273-1284. Date of Electronic Publication: 2024 Oct 14.
DOI: 10.1111/head.14842
Abstrakt: Objective: Describe the epidemiology of cluster headache (CH) using Veterans Health Administration (VHA) Electronic Health Record (EHR) data.
Background: Epidemiologic studies of CH at the population level are difficult because it has a prevalence of ~0.1%. Hospital system-wide studies are an attractive alternative as they have large numbers of patients and broader populations than headache or neurology clinic-based studies. The VHA is an ideal hospital-based system in which to study CH because it is nationwide, predominantly male, has a strong focus on mood disorders and suicidality, and has accessible individual medical records. Here, we report the first headache study based on an ongoing longitudinal cohort of patients with CH using VHA EHR data.
Methods: The VHA EHR data were accessed from Fiscal Year 2008 to 2019. Patients with CH consisted of all patients with at least one outpatient visit containing a CH diagnosis code from the International Classification of Diseases (ICD)-9 or -10. We extracted data on demographic features, incidence, and prevalence, as well as pain and psychiatric comorbidities.
Results: Of the 1,524,960 distinct patients who presented for headache treatment in the VHA between Fiscal Year 2008-2019, 24,131 had at least one visit with a CH diagnosis. The 1-year period prevalence of a CH diagnosis in the VHA ranges from 0.08% to 0.10% for women and 0.10% to 0.18% for men. A larger proportion of women versus men received a diagnosis of unspecified CH (59.6% [1412/2368] vs. 53.6% [11,663/21,763], p < 0.001). Most patients with CH had both comorbid headache and non-headache pain diagnoses. Headache not-otherwise-specified was the most common comorbid headache disorder at 70.0% (16,885/24,131) and was more common in women (76.1%, 1801/2368) compared to men (69.3%, 15,084/21,763). Other common comorbidities included migraine, depression, tobacco use, and obstructive sleep apnea. Rates of suicidal ideation or attempt were almost 50% higher in women (5-year proportion 9.4%, 222/2368) with CH compared to men (6.6%, 1433/21,763).
Conclusions: To our knowledge this is the largest hospital system study of CH to date and reinforces several previous studies. Pain, mental health, and sleep disorders comorbidities are particularly prevalent in this group and were often more common in women compared to men with CH. Future work should examine gender and race stratified prevalence estimates within the VHA and other healthcare systems.
(Published 2024. This article is a U.S. Government work and is in the public domain in the USA.)
Databáze: MEDLINE
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