Isolated headache in general practice: Determinants for delay in referral in patients with subarachnoid haemorrhage

Figures & data

Table I. Patients with subarachnoid haemorrhage (SAH) as present in a neurosurgical database (eight months data collection).

Patient characteristics	All patients with SAH	Patients with SAH and first contact by the GP	Patients with SAH who presented to the GP with isolated headache
n	112 (100%)	47	31
Age, years, mean, n (SD)	57 (15)	54 (16)	53 (16)
Male, n (%)	34 (30)	13	9
Deceased, n (%)	32 (29)	7	4
Unconsciousness, n (%)	47 (42)	3	n.a.
Clinical condition (WNFS)^a
Grade 5, n (%)	18 (16)	1	n.a.
Grade 4, n (%)	11 (10)	3	n.a.
Grade 3, n (%)	8 (7)	3	n.a.
Grade 2, n (%)	22 (20)	9	n.a.
Grade 1, n (%)	53 (47)	31	31
GP contact during office hours, n (%)	26 (23)	26	22
Contact with own GP, n (%)	23 (21)	23	19

^aWNFS score:

Grade 5: Coma or ‘in need of resuscitation’

Grade 4: Moderately decreased consciousness (with or without focal neurological symptoms).

Grade 3: slightly decreased consciousness with focal neurological symptoms present.

Grade 2: Slightly decreased consciousness with no focal neurological symptoms.

Grade 1: Only headache with no mental alteration or focal neurological symptoms.

Table II. Determinants of delayed versus immediately referred patients with subarachnoid haemorrhage (SAH) who presented with isolated headache to the GP (n = 31).

	Delayed referral n = 18	Immediate referral n = 13	Risk ratio	95% confidence interval
GP unaware of sudden onset
Yes (n)	10	0	2.6	1.5–4.5
No (n)	8	13
Patient's history of headaches
Yes (n)	7	1	1.8	1.1–3.0
No (n)	11	12
Patient delay
Yes (n)	13	4	2.1	1.0–4.5
No (n)	5	9

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