Emergency Medicine International

Research Article

Predictive Factors and Clinical Prediction Score for Serious Intracranial Causes in Acute Nontraumatic Headache at an Emergency Department

Table 1

Baseline characteristics, clinical presentation, and physical examination.


Characteristic	Nonserious intracranial headache (366 patients)	Serious intracranial headache (88 patients)	value

Age, years, median (IQR)	54.5 (42, 70)	51 (40, 64.2)	0.157
Male	131 (35.8)	41 (46.6)	0.08

Comorbidity
Diabetic mellitus	42 (11.5)	12 (13.6)	0.705
Hypertension	118 (32.2)	28 (31.8)	1
Hyperlipidemia	84 (23)	18 (20.5)	0.718
Atrial fibrillation	12 (3.3)	1 (1.1)	0.478
Ischemic heart disease	17 (4.6)	3 (3.4)	0.777
Cerebrovascular disease	29 (7.9)	8 (9.1)	0.887
HIV infection	5 (1.4)	7 (8)	0.003
Malignancy	21 (5.7)	14 (15.9)	0.003

Current medication
ASA	46 (12.6)	7 (8)	0.305
Clopidogrel	3 (0.8)	0 (0)	1
Anticoagulant	11 (3)	4 (4.5)	0.505
Prednisolone	0 (0)	2 (2.3)	0.037
Hormonal therapy	1 (0.3)	3 (3.4)	0.024

Clinical presentation
Gradual onset	308 (84.2)	55 (62.5)	<0.001
Abrupt onset	58 (15.8)	33 (37.5)	<0.001
Duration of headache >1 week	34 (9.3)	22 (25)	<0.001
Occipital pain	60 (16.4)	21 (23.9)	0.137
Pain score	7 (5, 8)	10 (8, 10)	<0.001
Awakening pain	41 (11.2)	42 (47.7)	<0.001
Worst headache ever	61 (16.7)	77 (87.5)	<0.001
Neck pain	61 (16.7)	29 (33)	<0.001
Nausea/vomiting	149 (40.7)	57 (64.8)	<0.001
Fever	26 (7.1)	22 (25)	<0.001
Positional provocation	5 (1.4)	4 (4.5)	0.076
Seizure	5 (1.4)	7 (8)	0.003

Physical examination
BT, °C, median (IQR)	36.6 (36.2, 36.9)	36.8 (36.2, 37.3)	0.008
SBP, mmHg, median (IQR)	144 (128, 161)	140.5 (127, 162)	0.621
PR, bpm, median (IQR)	76 (68, 88)	77 (67.5, 88.2)	0.89
RR, breath/min, median (IQR)	20 (20, 24)	24 (20, 24)	0.018
SpO₂, %, median (IQR)	99 (98, 100)	99 (97, 100)	0.006
Altered consciousness	1 (0.3)	6 (6.8)	<0.001
Localizing neurological deficit	13 (3.6)	20 (22.7)	<0.001
Stiffness of neck	4 (1.1)	15 (17)	<0.001

Data are presented as n (%) unless indicated otherwise. values <0.05 are statistically significant. IQR = interquartile range; HIV = human immunodeficiency virus; ASA = aspirin; BT = body temperature; SBP = systolic blood pressure; PR = pulse rate; bpm = beats per minute; SpO₂ = oxygen saturation.