1. Impacto das cefaleias em unidade de emergência da saúde suplementar e o uso de opioides
- Author
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Aline Vitali da Silva, Letícia Mayumi Carvalho Kiy, Caroline de Almeida Alves, Gabriela Cristina Kirylko, Valéria Aparecia Bello, and Regina Célia Poli-Frederico
- Subjects
Adult ,Male ,Emergency rooms ,medicine.medical_specialty ,emergency department ,Emergency unit ,cefaleia ,Migraine Disorders ,Neurosciences. Biological psychiatry. Neuropsychiatry ,migrânea ,opióde ,Young Adult ,03 medical and health sciences ,0302 clinical medicine ,Cephalalgia ,Health care ,Humans ,Medicine ,migraine ,book ,serviço de emergência ,book.periodical ,business.industry ,Incidence (epidemiology) ,Headache ,030208 emergency & critical care medicine ,Emergency department ,Middle Aged ,medicine.disease ,Analgesics, Opioid ,Neurology ,Migraine ,Opioid ,Emergency medicine ,opioid ,Female ,Neurology (clinical) ,Emergency Service, Hospital ,business ,headache ,Delivery of Health Care ,030217 neurology & neurosurgery ,RC321-571 ,medicine.drug - Abstract
Background: Headache is one of the most common causes of emergency care and migraines are the most common primary headache in this regard. Objective: The aim of this research study was to assess the incidence of medical consultations due to headache, along with demographic characteristics and treatments pertaining to cephalalgia that were offered to patients cared for in supplemental healthcare emergency rooms. Methods: In 2017, a total of 11,105 consultations took place, and 4,865 (43.8%) of them were complaints relating to headache. 407 records of patients with headache were randomly selected and assessed. Demographic, clinical and therapeutic data were collected using a structured form. Results: The cause of headache was diagnosed as migraine in 60.0% of the patient records. Patients were mostly female (75.2%), with an average age of 33.9 ± 13.7 years. Patient management consisted of administering dipyrone in 62.4% of cases, antiemetics in 66.9%, corticosteroids in 58.9%, opioids in 24.3% and NSAIDs in 13.5%. Use of opioids was associated with a diagnosis of migraine (OR 2.4; CI 1.4-3.9; p = 0.001). Patients who received opioids were kept under observation for longer periods of time (OR 3.4; CI 2.1-5.4; p < 0.001) and exhibited a higher rate of use of antiemetics (OR 11.0; CI 4.7-25.9; p < 0.001), compared with patients who did not receive opioids. Conclusion: Dipyrone and antiemetics were administered to most of the patients. Opioids were used for a significant proportion of these individuals, despite the diagnosis of migraine, a condition for which their use is discouraged. RESUMO Introdução: Cefaleia é uma das causas mais frequentes de atendimentos de emergência, sendo que a migrânea é a cefaleia primária mais comum nesse contexto. Objetivo: Avaliar a frequência de atendimentos por cefaleias, bem como as características demográficas e o tratamento oferecido aos pacientes atendidos em Pronto Atendimento da Saúde Suplementar. Métodos: No ano de 2017 foram realizados 11.105 atendimentos, sendo 4.865 (43,8%) por queixa de cefaleia. Foram selecionados randomicamente a analisados 407 prontuários de pacientes com cefaleia. Os dados demográficos, clínicos e terapêuticos foram coletados através de formulário estruturado. Resultados: A causa da cefaleia foi diagnosticada como migrânea em 60,0% dos prontuários. Os pacientes eram em sua maioria do sexo feminino (74,9%), com média de idade de 33,9±13,7 anos. O manejo dos pacientes constitui-se na administração de dipirona em 62,4%, antiemético 66,9%; corticóide 58,9%, opióide 24,3% e, por fim, AINE foi utilizado em 13,5% dos casos. O uso de opióide foi associado ao diagnóstico de migrânea (OR 2,4; CI 1,4-3,9; p=0,001). Pacientes que receberam opióide também tiveram maior tempo de permanência (OR 3,4; IC 2,1-5,4; p
- Published
- 2021