Volume 27, Issue 136, June 2023

Migraine in emergency department; a retrospective analysis of the attendances at a major city hospital in Riyadh, Saudi Arabia

Osama Mohammed Binbakheet¹, Wael Obaid Aladham Alanazi², Hend Hamoud Alshammari², Abdelwahed Sayar Alenezy³, Abdulaziz Abdullah Mohammed Hussain⁴, Ammar Ahmad Hassan Alasiri⁴, Fahad Awad Asiri⁴, Sarah Ahmed Alghamdi⁵, Farah Ahmed Alghamdi⁵, Hashim Marshud R Alsaedi⁶, Fahad Hadram Alasemr Alharbi⁶, Rayan Dhaif Allah A Alamri⁶

¹Saudi Board Certified in Emergency Medicine, Emergency Department, Ministry of health, First health cluster, Riyadh, Kingdom of Saudi Arabia
²Emergency Resident, Emergency department, Security Forces Hospital, Riyadh, Kingdom of Saudi Arabia
³Emergency Consultant, Security Forces Hospital, Riyadh, Saudi Arabia
⁴Medical Student, King Khalid University, Abha, Saudi Arabia
⁵Medical Intern, Medical University of Silesia, Katowice, Poland
⁶Laboratory technician, Regional laboratory, Medina, Saudi Arabia

ABSTRACT

Saudi Arabia has the highest rates for migraine, per the Global Summary of the Eastern Mediterranean Region. A recent audit found that 30% of patients with headache-related ED discharge data had been given a migraine diagnosis. For future endeavors to offer alternatives to headache care, it is crucial to understand the features of these emergency migraine attendances. The goal of this study is to describe the characteristics, diagnostic techniques and therapeutic strategies used in migraine patients who sought treatment at King Saud Medical City (KSMC) and security forces hospital in emergency room in Riyadh, Saudi Arabia, during the course of a five-month study period. Migraine C-E criteria according to Headache International Classification were used to categorise adult emergency department headache visits and evaluate attendance characteristics. Because there was inadequate proof of headache symptoms, 221 (24.8%) study participants could not be categorized. 202 (22.6%) of the 670 trial participants who were present experienced headaches or were likely to have migraines based on satisfying criteria C-E of the ICHD-3. The majority of attendances—147 or 72.7%—had symptoms that had lasted more than 24 hours when they came, with 65 attendances (32.1%) happening less than four days following headache onset. A healthcare professional suggested 37 attendances. This analysis reveals how inadequate acute care and a mismatch between migraine diagnosis and coding contribute to under reporting. We advise additional analysis of the identified populations and the usage of headache proforma.

Keywords: Migraine, Emergency department, Headache, Severe headache, Recurrent headache

Medical Science, 2023, 27, e271ms3092

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DOI: https://doi.org/10.54905/disssi/v27i136/e271ms3092

Published: 23 June 2023