Featured Research

from universities, journals, and other organizations

Decision-making tool may help rule out brain hemorrhage in ER

Date:
September 24, 2013
Source:
American Medical Association (AMA)
Summary:
Researchers have developed a simple clinical decision rule that may help doctors identify patients with headache in the emergency department who have subarachnoid hemorrhage (bleeding in a certain area of the brain).

Researchers have developed a simple clinical decision rule that may help doctors identify patients with headache in the emergency department who have subarachnoid hemorrhage (bleeding in a certain area of the brain), according to a study in the September 25 issue of JAMA.

“Headache accounts for approximately 2 percent of all emergency department visits, and subarachnoid hemorrhage is one of the most serious diagnoses, accounting for only 1 percent to 3 percent of these headaches. Although the decision to evaluate patients with new neurologic deficits is relatively straightforward, it is much more difficult to determine which alert, neurologically intact patients who present with headache alone require investigations—yet such patients account for half of all subarachnoid hemorrhages at initial presentation,” according to background information in the article.

A clinical decision rule is a tool that uses 3 or more variables from the history, examination, or simple tests to predict a diagnosis for a patient. These rules help clinicians make diagnostic or treatment decisions. The investigators had previously developed three clinical decision rules for use in patients with headache to determine which patients require investigation (imaging, lumbar puncture) for subarachnoid hemorrhage.

Jeffrey J. Perry, M.D., M.Sc., of the Ottawa Hospital Research Institute, Ottawa, Canada, and colleagues further studied the 3 rules in a group of neurologically intact patients with acute headache at 10 Canadian emergency departments from April 2006 to July 2010 to determine which might be most useful and accurate.

Among 2,131 adult patients with a headache peaking within 1 hour and no neurologic deficits, 132 (6.2 percent) had subarachnoid hemorrhage. The researchers found that information about age, neck pain or stiffness, witnessed loss of consciousness, onset during exertion, "thunderclap headache" (defined as instantly peaking pain) and limited neck flexion on examination (defined as inability to touch chin to chest or raise the head 3 inches off the bed if supine [lying face upward]), was 100 percent sensitive (detected all cases), but only 15.3 percent specific (designated many patients without SAH as possibly having it). The authors named the rule the Ottawa SAH (subarachnoid hemorrhage) Rule.

The authors write that the rule may provide evidence for physicians to use in deciding which patients require imaging to decrease the relatively high rate of missed subarachnoid hemorrhages.


Story Source:

The above story is based on materials provided by American Medical Association (AMA). Note: Materials may be edited for content and length.


Cite This Page:

American Medical Association (AMA). "Decision-making tool may help rule out brain hemorrhage in ER." ScienceDaily. ScienceDaily, 24 September 2013. <www.sciencedaily.com/releases/2013/09/130924174201.htm>.
American Medical Association (AMA). (2013, September 24). Decision-making tool may help rule out brain hemorrhage in ER. ScienceDaily. Retrieved August 1, 2014 from www.sciencedaily.com/releases/2013/09/130924174201.htm
American Medical Association (AMA). "Decision-making tool may help rule out brain hemorrhage in ER." ScienceDaily. www.sciencedaily.com/releases/2013/09/130924174201.htm (accessed August 1, 2014).

Share This




More Health & Medicine News

Friday, August 1, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

House Republicans Vote to Sue Obama Over Healthcare Law

House Republicans Vote to Sue Obama Over Healthcare Law

Reuters - US Online Video (July 31, 2014) The Republican-led House of Representatives votes to sue President Obama, accusing him of overstepping his executive authority in making changes to the Affordable Care Act. Mana Rabiee reports. Video provided by Reuters
Powered by NewsLook.com
Despite Health Questions, E-Cigs Are Beneficial: Study

Despite Health Questions, E-Cigs Are Beneficial: Study

Newsy (July 31, 2014) Citing 81 previous studies, new research out of London suggests the benefits of smoking e-cigarettes instead of regular ones outweighs the risks. Video provided by Newsy
Powered by NewsLook.com
Dangerous Bacteria Kills One in Florida

Dangerous Bacteria Kills One in Florida

AP (July 31, 2014) Sarasota County, Florida health officials have issued a warning against eating raw oysters and exposing open wounds to coastal and inland waters after a dangerous bacteria killed one person and made another sick. (July 31) Video provided by AP
Powered by NewsLook.com
Health Insurers' Profits Slide

Health Insurers' Profits Slide

Reuters - Business Video Online (July 30, 2014) Obamacare-related costs were said to be behind the profit plunge at Wellpoint and Humana, but Wellpoint sees the new exchanges boosting its earnings for the full year. Fred Katayama reports. Video provided by Reuters
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:

Breaking News:
from the past week

In Other News

... from NewsDaily.com

Science News

Health News

Environment News

Technology News



Save/Print:
Share:

Free Subscriptions


Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

Get Social & Mobile


Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

Have Feedback?


Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
Mobile: iPhone Android Web
Follow: Facebook Twitter Google+
Subscribe: RSS Feeds Email Newsletters
Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins