Identifying the cause of headaches in pediatric emergency departments (PEDs) can be challenging due to the lack of comprehensive research. This study aims to identify the frequency, characteristics, and unnecessary diagnostic procedures of patients with headaches in the PED setting. A six-month cross-sectional study was conducted at the PED of Alexandria University Children's Hospital, including all children with headaches. Children were classified as having primary headache (PH), secondary benign headache (SBH), and secondary serious headache (SSH) according to predetermined criteria. Logistic regression was employed to analyze the risk factors associated with SSH. A total of 164 visits to the PED were recorded, out of a total of 22,662 visits, accounting for approximately 0.72% of all visits and 1.17% of the total number of children admitted. PH was the most common cause, accounting for 61.0% of cases, followed by SSH with 24.4%, whereas SBH was the least common with 13.4%. Abnormal neurological examination (odds ratio, 53.752 [1.628 to 1774.442], = 0.026∗) was found to have a strong and statistically significant association with SSH in the multivariate analysis. Regarding the appropriateness of the investigations conducted, it was found that over half (66.5%) of the cases had unnecessary neuroimaging, with 52% of these cases being children with PH. Headaches in children are commonly reported during visits to the PED. PH was the most prevalent, followed by SSH, whereas SBH was the least common. Many of the children received inaccurate first diagnoses and performed unnecessary laboratory tests, neuroimaging, and other tests, mostly electroencephalography.

中文翻译：

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急诊科头痛儿童的临床特征和检查的适当性

由于缺乏全面的研究，确定儿科急诊科 (PED) 头痛的原因可能具有挑战性。本研究旨在确定 PED 环境中头痛患者的频率、特征和不必要的诊断程序。亚历山大大学儿童医院的 PED 进行了一项为期六个月的横断面研究，研究对象包括所有患有头痛的儿童。根据预定标准，儿童被分为原发性头痛（PH）、继发性良性头痛（SBH）和继发性严重头痛（SSH）。采用Logistic回归分析与SSH相关的危险因素。在总共 22,662 次就诊中，共有 164 次就诊，约占总就诊次数的 0.72%，占入院儿童总数的 1.17%。 PH 是最常见的原因，占病例的 61.0%，其次是 SSH，占 24.4%，而 SBH 是最不常见的，占 13.4%。在多变量分析中发现，神经系统检查异常（比值比，53.752 [1.628 至 1774.442]，= 0.026*）与 SSH 有很强的且具有统计学意义的关联。关于调查的适当性，发现超过一半（66.5%）的病例进行了不必要的神经影像检查，其中 52% 的病例是肺动脉高压儿童。在就诊 PED 期间，经常报告儿童头痛。 PH 最常见，其次是 SSH，而 SBH 最不常见。许多孩子的初次诊断不准确，并进行了不必要的实验室检查、神经影像学和其他检查，主要是脑电图检查。