Emergency Departments: demographics, work-up and frequency of pathological

Headache is a common complaint in the emergency department (ED). In order to examine headache work-ups and diagnoses across the USA, we queried a repre-sentative sample of adult ED visits (the National Hospital Ambulatory Medical Care Survey) for the years 1992–2001. Headache accounted for 2.1 million ED visits per year (2.2 % of visits). Of the 14 % of patients who underwent neuroim-aging, 5.5 % received a pathological diagnosis. Of the 2 % of patients who under-went lumbar puncture, 11 % received a pathological diagnosis. On multivariable analysis, a decreased rate of imaging was noted for patients without private insurance [odds ratio (OR) 0.61, confidence interval (CI) 0.44, 0.86] and for those presenting off-hours (OR 0.55, CI 0.39, 0.77). Patients over 50 were more likely to receive a pathological diagnosis (OR 3.3, CI 1.2, 9.3). In conclusion, clinicians should ensure that appropriate work-ups are performed regardless of presenta-tion time or insurance status, and be vigilant in the evaluation of older patients. Headache, emergency department, diagnosis, etiolog