Diagnostic Delay and Its Predictors in Cluster Headache

被引:7
|
作者
Kim, Byung-Su [1 ]
Chung, Pil-Wook [2 ]
Kim, Byung-Kun [3 ]
Lee, Mi Ji [4 ]
Chu, Min Kyung [5 ]
Ahn, Jin-Young [6 ]
Bae, Dae Woong [7 ]
Song, Tae-Jin [8 ]
Sohn, Jong-Hee [9 ]
Oh, Kyungmi [10 ]
Kim, Daeyoung [11 ]
Kim, Jae-Moon [11 ]
Park, Jeong Wook [12 ]
Chung, Jae Myun [13 ]
Moon, Heui-Soo [2 ]
Cho, Soohyun [14 ]
Seo, Jong-Geun [15 ]
Kim, Soo-Kyoung [16 ,17 ]
Choi, Yun-Ju [18 ]
Park, Kwang-Yeol [19 ]
Chung, Chin-Sang [4 ]
Cho, Soo-Jin [20 ]
机构
[1] Bundang Jesaeng Gen Hosp, Daejin Med Ctr, Dept Neurol, Seongnam, South Korea
[2] Sungkyunkwan Univ, Kangbuk Samsung Hosp, Dept Neurol, Sch Med, Seoul, South Korea
[3] Eulji Univ, Eulji Hosp, Dept Neurol, Seoul, South Korea
[4] Sungkyunkwan Univ, Neurosci Ctr, Samsung Med Ctr, Dept Neurol,Sch Med, Seoul, South Korea
[5] Yonsei Univ, Severance Hosp, Dept Neurol, Coll Med, Seoul, South Korea
[6] Seoul Med Ctr, Dept Neurol, Seoul, South Korea
[7] Catholic Univ Korea, Coll Med, Dept Neurol, Suwon, South Korea
[8] Ewha Womans Univ, Seoul Hosp, Coll Med, Dept Neurol, Seoul, South Korea
[9] Hallym Univ, Chuncheon Sacred Heart Hosp, Dept Neurol, Coll Med, Chunchon, South Korea
[10] Korea Univ, Dept Neurol, Coll Med, Seoul, South Korea
[11] Chungnam Natl Univ, Dept Neurol, Coll Med, Daejeon, South Korea
[12] Catholic Univic Korea, Uijeongbu St Marys Hosp, Dept Neurol, Coll Med, Uijongbu, South Korea
[13] Inje Univ, Dept Neurol, Coll Med, Seoul, South Korea
[14] Eulji Univ, Dept Neurol, Uijongbu, South Korea
[15] Kyungpook Natl Univ, Sch Med, Dept Neurol, Daegu, South Korea
[16] Gyeongsang Natl Univ, Dept Neurol, Coll Med, Jinju, South Korea
[17] Gyeonsang Natl Univ Hosp, Jinju, South Korea
[18] Dr Chois Neurol Clin, Jeonju, South Korea
[19] Chung Ang Univ Hosp, Dept Neurol, Seoul, South Korea
[20] Hallym Univ, Dongtan Sacred Heart Hosp, Dept Neurol, Coll Med, Hwaseong, South Korea
来源
FRONTIERS IN NEUROLOGY | 2022年 / 13卷
基金
新加坡国家研究基金会;
关键词
headache; primary headache disorder; cluster headache; delayed diagnosis; Korea; INTERNATIONAL CLASSIFICATION; CLINICAL-FEATURES; DEPRESSION;
D O I
10.3389/fneur.2022.827734
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
ObjectiveCluster headache (CH) is a rare, primary headache disorder, characterized of excruciating, strictly one-sided pain attacks and ipsilateral cranial autonomic symptoms. Given the debilitating nature of CH, delayed diagnosis can increase the disease burden. Thus, we aimed to investigate the diagnostic delay, its predictors, and clinical influence among patients with CH. MethodsData from a prospective multicenter CH registry over a 4-year period were analyzed. CH was diagnosed according to the International Classification of Headache Disorders (ICHD)-3 criteria, and diagnostic delay of CH was assessed as the time interval between the year of the first onset and the year of CH diagnosis. Patients were classified into three groups according to the tertiles of diagnostic delay (1st tertile, <1 year; 2nd tertile, 1-6 years; and 3rd tertile, >= 7 years). ResultsOverall, 445 patients were evaluated. The mean duration of diagnosis delay was 5.7 +/- 6.7 years, (range, 0-36 years). Regarding the age of onset, majority of young patients (age <20 years) belonged to the third tertile (60%), whereas minority of old patients (>40 years) belonged to the third tertile (9.0%). For year of onset, the proportion of patients in the 3rd tertile was the highest for the groups before the publication year of the ICHD-2 (74.7%) and the lowest for the groups after the publication year of the ICHD-3 beta version (0.5%). Compared with the first CH, episodic CH [multivariable-adjusted odds ratio (aOR) = 5.91, 95% CI = 2.42-14.48], chronic CH (aOR = 8.87, 95% CI = 2.66-29.51), and probable CH (aOR = 4.12, 95% CI = 1.48-11.43) were associated with the tertiles of diagnostic delay. Age of onset (aOR = 0.97, 95% CI = 0.95-0.99) and PHQ-9 score (aOR = 0.96, 95% CI = 0.93-0.99) were inversely associated with the tertile of diagnostic delay. The prevalence of suicidal ideation was highest in the patients of the third tertile. The mean HIT-6 score increased significantly with the diagnostic delay (p = 0.041). ConclusionsPatients with a younger onset of CH have a higher risk of diagnostic delay. Nevertheless, the rate of delayed diagnosis gradually improved over time and with the publication of the ICHD criteria, supporting the clinical significance of diagnostic clinical criteria and headache education to reduce the disease burden of CH.
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页数:10
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