@article{ref1,
title="Monthly variation of United States pediatric headache emergency department visits",
journal="Cephalalgia",
year="2014",
author="Kedia, Sita and Ginde, Adit A. and Grubenhoff, Joseph A. and Kempe, Allison and Hershey, Andrew D. and Powers, Scott W.",
volume="34",
number="6",
pages="473-478",
abstract="OBJECTIVE: The objective of this article is to determine the monthly variation of emergency department (ED) visits for pediatric headache. We hypothesized youth have increased headache-related ED visits in the months associated with school attendance. <br><br>METHODS: Using a United States representative sample of ED visits in the National Hospital Ambulatory Medical Care Survey from 1997 to 2009, we 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). <br><br>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). <br><br>CONCLUSIONS: In adolescents we 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.<p /> <p>Language: en</p>",
language="en",
issn="0333-1024",
doi="10.1177/0333102413515346",
url="http://dx.doi.org/10.1177/0333102413515346"
}