Predictors of Short‐Term Prognosis While in Pediatric Headache Care: An Observational Study
| Autor: | Joanne Kacperski, Jessica Weberding, Scott W. Powers, Marielle A. Kabbouche, Serena L. Orr, Shannon White, Abigail Turner, Mimi N. Miller, Paul S. Horn, Hope L. O’Brien, Susan L. LeCates, Andrew D. Hershey |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
Male
Pediatrics medicine.medical_specialty Outpatient Clinics Hospital Adolescent Migraine Disorders Population Severity of Illness Index Article 03 medical and health sciences Sex Factors 0302 clinical medicine Chronic Migraine medicine Humans 030212 general & internal medicine Young adult Child education Retrospective Studies education.field_of_study business.industry Age Factors Retrospective cohort study Hospitals Pediatric Prognosis medicine.disease Combined Modality Therapy Outcome and Process Assessment Health Care Neurology Migraine Chronic Disease Disease Progression Anxiety Female Observational study Neurology (clinical) Headaches medicine.symptom business 030217 neurology & neurosurgery Follow-Up Studies |
| Zdroj: | Headache: The Journal of Head and Face Pain. 59:543-555 |
| ISSN: | 1526-4610 0017-8748 |
| Popis: | OBJECTIVES: To characterize the short-term prognosis of a clinical population of pediatric and young adult patients with migraine and explore predictors of clinical worsening while in care. METHODS: This was a retrospective study of all migraine patients seen at the Cincinnati Children’s Hospital Headache Center from 09/01/2006 to 12/31/2017, who had at least one follow-up visit within 1–3 months of the index visit analyzed. Included data were: age, sex, race, primary ICHD diagnosis, chronic migraine, medication overuse, history of status migrainosus, BMI percentile, headache frequency, headache severity, PedMIDAS score, allodynia, preventive treatment type, lifestyle habits, disease duration, depressive and anxiety symptoms. Clinical worsening was defined as an increase of 4 or more headache days per month between the index visit and the follow-up visit. RESULTS: Data for 13,160 visit pairs (index and follow-up), from 5,316 patients were analyzed. Clinical worsening occurred in only 14.5% (1,908/13,160), whereas a reduction in headache frequency was observed in 56.8% of visit intervals (7,475/13,160), with 34.8% of the intervals (4,580/13,160) showing a reduction of 50% or greater. The change in headache frequency was minimal (increase in 0–3 headaches/month) in 28.7% of intervals (3,737/13,160). In the multivariable model, the odds of worsening were significantly higher with increasing age, female sex, chronic migraine, status migrainosus, depressive symptoms, higher PedMIDAS scores, and use of nutraceuticals, whereas the odds of worsening were lower for summer visits, caffeine drinkers, higher headache frequencies and use of pharmaceuticals. CONCLUSIONS: The majority of pediatric patients who receive multimodal interdisciplinary care for migraine improve over time. Our findings highlight a set of clinical features that may help in identifying specific factors that may contribute to an unfavorable short-term prognosis. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Plný text