Abstract Details

Title Clinical Predictors associated with Persistent versus Acute Post-Traumatic Headache

Topic Headache

Presentation(s) P15 - Poster Session 15 (12:00 PM-1:00 PM)

Poster/Presentation
Number 7-002

Objective To identify any clinical predictors associated with persistent versus acute post-traumatic headache.

Background Persistent post-traumatic headache (PTH) is defined as a headache developing within 7 days of an injury that lasts for greater than 3 months. However, there is no evidence available for the distinction between persistent and acute PTH based on clinical phenotypes.

Design/Methods We conducted a retrospective study using the Stanford Research Repository Cohort Discovery Tool. We reviewed 500 electronic patient charts between January 2015 to September 2019 using inclusion criteria of adults older than 18 years with a diagnosis of PTH. The following variables were extracted from each patient’s chart: diagnosis of PTH as dependent variable, and predictor variables as age, sex, history of migraine, loss of consciousness during head injury, previous psychological history, duration of PTH, new PTH-associated comorbidities (e.g. new onset vertigo, post-traumatic stress disorder). Logistic regression was employed to identify clinical phenotypes predicting persistent PTH. All predictor variables were tested in one block to determine their predictive capacity while controlling for other predictors in the model.

Results A total of 300 patients were included (150 acute, 150 persistent PTH) with a median age of 47 years (IQR 31, 59) and female: male ratio of 2.7:1. 200 patients were excluded from misdiagnoses. History of psychological comorbidities (standardized beta 0.16), history of migraine (0.20), new PTH-associated comorbidities (0.23) and medication overuse (0.37) statistically significantly predicted the presence of persistent PTH (p < 0.0001). Duration of persistent PTH did not impact other clinical variables. Goodness-of-fit statistics showed the predictive capacity of the model was fit and appropriate (Cox & Snell R square 0.46, Nagelkerke R square 0.61, Hosmer and Lemeshow test p = 0.34).

Conclusions Psychological comorbidities, history of migraine, new PTH-associated comorbidities and medication overuse predicted the occurrence of persistent PTH. Management emphasis should focus on these phenotypes.

Authors/Disclosures
Lik Hang Tommy Chan, MD (Western University) PRESENTER	No disclosure on file
Yohannes W. Woldeamanuel, MD (Mayo Clinic Arizona)	Dr. Woldeamanuel has received personal compensation in the range of $0-$499 for serving as a Consultant for Atheneum. Dr. Woldeamanuel has received personal compensation in the range of $0-$499 for serving as a Consultant for Research Square. The institution of Dr. Woldeamanuel has received research support from NINDS. Dr. Woldeamanuel has a non-compensated relationship as a Chief Medical Officer, Co-Founder with Ex-Amplify Therapeutics that is relevant to �鶹��ýӳ�� interests or activities. Dr. Woldeamanuel has a non-compensated relationship as a Adjunct Faculty with Arizona State University that is relevant to �鶹��ýӳ�� interests or activities. Dr. Woldeamanuel has a non-compensated relationship as a Founder & Consultant with Advanced Clinical & Research Center that is relevant to �鶹��ýӳ�� interests or activities.

�鶹��ýӳ��

�鶹��ýӳ��