Individuals with Migraine Presenting in Emergency Department Often Return

A study looking to determine the frequency of emergency department revisits in New York City found that many patients with migraine frequently return within a 6-month period. The results were published in the November edition of Headache.

Migraine leads to more than 1.2 million visits to emergency departments in the United States annually. The authors analyzed 18 emergency departments in New York City in search of the frequency of revisits, as well as sociodemographic factors.

According to the study, 1052 individuals with migraine visited the emergency department in the first 6 months of 2015. After the initial visit, 277 patients (26.3%) revisited within 6 months. Of those visits, 4% occurred within the first 24 hours, 9% within 72 hours, 27.4% within the first month, and nearly half within the first 3 months.

Researchers found no connection between revisits and age, gender, or socioeconomic status.

They also noted that the study was limited by not evaluating data prior to 2015, as some visits could have been revisits. The study also did not look beyond the 18 emergency departments.

The study concluded that more work needs to be done to target specific interventions that would decrease revisits for individuals with headache and migraine. This result concurs with other studies conducted this year related to migraine and emergency department visits.

An Australian study looked at the use of acupuncture in the emergency department to provide pain relief. While acupuncture was found to be effective for back pain and ankle sprains, it was ineffective for individuals with migraine. Also, new research presented in June looked at the use of opioids for individuals with migraine in the emergency department. The study found patients who received prochlorperazine were twice as likely to have a good outcome compared to a patient who received opioids.  This is consistent with consensus opinion from headache experts who advise against the use of opiates for the treatment of migraine.

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