Pediatric emergency department visits due to headaches depend on the month

A study that looked at monthly changes in emergency department visits for children caused by headaches shows that children are more likely to go to the emergency department after they return to school from winter or summer breaks. The authors believe this is due to a change in daily lifestyle.

The objective of this article is to determine the monthly variation of emergency department (ED) visits for pediatric headache. The authors hypothesized youth have increased headache–related ED visits in the months associated with school attendance. In adolescents they found higher ED utilization in January and September, the same months associated with school return from vacation for a majority of children nationally. No significant reduction in the summer suggests that school itself is not the issue, but rather changes in daily lifestyle and transitions.

Methods

• Using a United States representative sample of ED visits in the National Hospital Ambulatory Medical Care Survey from 1997 to 2009, the authors estimated number of visits associated with ICD-9 codes related to headache, migraine, status migrainosus, or tension-type headache in 5- to 18-year-olds.
• Age-stratified multivariate models are presented for month of visit (July as reference).

Results

• There was a national estimate of 250,000 ED visits annually related to headache (2.1% of total visits) in 5- to 18-year-olds.
• In 5- to 11-year-olds, the adjusted rate of headache-related visits was lower in April (OR 0.42, 95% CI 0.20, 0.88).
• In 12- to 18-year-olds, there were higher rates in January (OR 1.92, 95% CI 1.16, 3.14) and September (OR 1.64, 95% CI 1.06, 2.55).

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