Table 5.
Clinically-relevant composite categories of variables from patient history and examination: Bivariable association with receiving ED neuroimaging.
| Category | n (%) | Received ED neuroimaging if finding was present, n/N (%) | Received ED neuroimaging if finding was absent, n/N (%) | RR (95% CI) | Unsure or missing2 |
|---|---|---|---|---|---|
| Positional symptoms1* | 136 (60.7) | 65/136 (47.8) | 9/88 (10.2) | 4.7 (2.5, 8.9) | 0 |
| Abnormal neurological exam finding (other than altered mental status) * | 20 (8.9) | 16/20 (80) | 58/202 (28.7) | 2.8 (2.0, 3.8) | 2 (0.9) |
| Extreme pain intensity of presenting headache* | 126 (56.3) | 54/126 (42.9) | 17/92 (18.5) | 2.3 (1.4, 3.7) | 6 (2.7) |
| Vomiting (any) * | 71 (31.7) | 37/71 (52.1) | 37/153 (24.2) | 2.2 (1.5, 3.1) | 0 |
| Valsalva- or exertion-related symptoms* | 64 (28.6) | 31/64 (48.4) | 33/136 (24.3) | 2.0 (1.4, 2.9) | 24 (10.7) |
| Neurological or neurocognitive dysfunction* | 68 (30.4) | 33/68 (48.5) | 41/156 (26.3) | 1.8 (1.3, 2.6) | 0 |
| Change in headache characteristics* | 100 (44.6) | 42/100 (42) | 31/115 (27) | 1.6 (1.1, 2.3) | 9 (4.0) |
| Symptoms concerning for subarachnoid hemorrhage* | 72 (32.1) | 31/72 (43.1) | 43/152 (28.3) | 1.5 (1.1, 2.2) | 0 |
| Young age (i.e. 2–6 years old) | 26 (11.6) | 9/26 (34.6) | 65/133 (32.8) | 1.1 (0.6, 1.9) | 0 |
| Occipital location of headache | 43 (19.2) | 13/43 (30.2) | 61/181 (33.7) | 0.9 (0.5, 1.5) | 0 |
| Abnormal physical exam finding | 7 (3.1) | 1/7 (14.3) | 68/205 (33.2) | 0.4 (0.1, 2.7) | 12 (5.4) |
1
A symptom such as headache or vomiting that changes or is associated with a change in position, or prolonged supine position.
2
Unsure and missing variables from individual findings were combined when categories created, and all analyzed as missing.
*
p<0.05.