Use of Emergency Medical Services by headache patients in a Greek metropolitan population

Background

In the absence of effective pre-hospital health care facilities in Greece, patients with acute or chronic pain are forced to present immediately to the Emergency Outpatient Departments (EOD) of the on-call public hospitals. Thus, the treatment of headache patients may result in a relevant increase in the burden of work of the EOD.

Materials and methods

In an open prospective study design, epidemiological and clinical data were collected from all patients presenting with headache as their main symptom at the Emergency Outpatient Department (EOD) of Papageorgiou Hospital, a tertiary health care facility in metropolitan Thessaloniki, from August 2006 to January 2007.

Results

During the study period, a total of 2813 patients presented at the EOD. 420 (14,9 %) of those patients complained about headache as their main symptom. They were 133 (31,6% of headaches) men, 291 (68,4%) women, with a mean age of 36,6 years in male and 39,7 years in female headache patients. A primary headache was diagnosed in 214 (50,9%) patients, secondary headache in 101 (24,0%) patients and 105 (25,1%) patients did not fulfil the diagnostic criteria for a distinct headache. 65 (15,4%) patients were admitted to hospital, about half of them (n=30, 7,1%) to a one day care unit, and 35 (8,30%) to a ward). 24 (5,7%) patients arrived with public emergency transport services, but only 11 were admitted to hospital.

Conclusions

Subjective and objective severity of headache consi-derably increase the burden of the local EOD to a degree that turns use of EOD into misuse.