Analyses Of Consulted Headache Patients And Related Predictor: An Outpatient Clinic Study

Objective This study aimed to survey the classification and analysis repeated consultation predictors about headache in neurological out-patients.Methods Personal interview was carried out consecutively for the neurological outpatients who suffered headache as the chief reason for visit. A self-administered questionnaire was used to collect medical records. Headache diagnoses were given by the doctors, according to the International Classification of Headache Disorders, 2nd edition. Logistic regression was used to detect the repeated consultation predictors for physician.Results Patients with chief complaint of headache accounted for 19.5% (1806/9282) of the total general neurology clinic out-patients. A total of 1683 cases of headache patients were investigated. Female dominated the majority, accounting for 68.1%. A total of 843(50.1%) patients were defined as primary headache, followed 454(27%) secondary headache and 386(22.9%) headache not other specified. Migraine 401(23.8%) and tension-type headache (TTH) 399(23.7%) were the two most common headache types. The age distribution between 35and 44 years dominated the majority primary headache, especially migraine and TTH patients; while for secondary headaches, most of them were older than 55 years. Migraine patients suffered from a more severe headache intensity, longer than 6 years of headache history and more common analgesic medications use than TTH ones (p<0.001). TTH patients had more frequent episodes of headaches than migraines, especially frequency of more than 15days/month (p<0.001). 22.8% primary headache patients were defined as chronic daily headache (CDH). Of all the CDH patients, 23.4% (45/192) patients had medication-overuse headache (MOH). In MOH patients, more than 91.1% patients overuse combination analgesic medications. 68.6% patients of migraine and 64.9% TTH reported having visited physicians once or more for their headaches (p>0.05). The repeated consultation predictors for migraine were headache profile of nausea (odds ration, OR=2.07, the headache duration of more than 6years (OR=3.0) and older age, while for TTH, only headache frequency of≥15days/month (OR=2.1) was the significant predictors.Conclusion One fifth of out-patients visited to a general neurology department are headache patients. The majority are patients suffered from primary headache, especially migraine and TTH. TTH patients should be paid equally attention just like migraine. For out-patients, migraine patients should be given more attention on headache intensity and duration of headache history, while for TTH ones, to the headache frequency. Although there were no significantly different consultation between migraine and TTH patients, headache profile of nausea, duration of headaches, older age in migraine and headaches frequency in TTH sufferers were found to be independently associated with the likelihood of repeated consultation, respectively. Headache management is not satisfied and more attention is needed.