Observational studyThe western journal of emergency medicine2026
Acute Headache Management and Emergency Department Throughput: A Multicenter Retrospective Analysis.
Observational study in The western journal of emergency medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionHeadache is a common presentation to the emergency department (ED), requiring both accurate diagnosis and efficient management. Although consensus guidelines exist, real-world treatment practices and their associations with operational outcomes remain variable. We evaluated the association between acute headache management strategies-including medications, diagnostic imaging, and consultations-and ED length of stay (LOS), using both unadjusted and multivariable-adjusted analyses.
methodsWe conducted a multicenter retrospective observational study using data from 79,527 adult ED encounters for headache across 22 EDs in the southwestern and upper Midwestern United States between 2018 and 2024. The primary outcome was ED LOS. Secondary outcomes included LOS differences associated with medication classes, imaging modalities, procedures, and specialty consultations. Length of stay differences by treatment strategy were compared using Mann-Whitney U testing. We performed multivariable linear regression and quantile regression (median) adjusting for age, sex, Emergency Severity Index level, disposition, imaging, procedures, consultations, site, and year. Encounters were classified by headache type (primary, secondary, or unspecified) using discharge diagnosis codes, and stratified analyses were performed.
resultsPrimary headache encounters comprised 19.4% of the cohort (n = 15,413), secondary headache 14.0% (n = 11,147), and unspecified headache 66.6% (n = 52,967). The overall median LOS was 183 minutes (interquartile range [IQR], 119-276). In unadjusted analyses, nonsteroidal anti-inflammatory drug (NSAID) (median 180 vs 185 minutes; P = .42) and triptan administration (177 vs 183 minutes; P = .49) were not associated with longer LOS. In contrast, antiseizure medications (+136 minutes; P < .001), intravenous magnesium (+101 minutes; P < .001), opioids (+89 minutes; P < .001), and benzodiazepines (+72 minutes; P < .001) were associated with the longest LOS. In multivariable-adjusted analysis (R
conclusionIn this multicenter retrospective study, most pharmacologic and diagnostic interventions-aside from NSAIDs and triptans-were associated with longer ED LOS, even after adjusting for patient and clinical covariates. These associations likely reflect both direct treatment effects and confounding by indication. Prospective studies are needed to evaluate whether standardized protocols can improve ED throughput while maintaining care quality.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.