The Prevalence and Burden of Migraine and Severe Headache in the United States: Updated Statistics From Government Health Surveillance Studies
The Prevalence and Burden of Migraine and Severe Headache in the United States: Updated Statistics From Government Health Surveillance Studies
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DOI：
10.1111/head.12482
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发表时间：
2015-01-01
期刊：
影响因子：
5
通讯作者：
Smitherman, Todd A.
中科院分区：
文献类型：
--
作者：
Burch, Rebecca C.;Loder, Stephen;Smitherman, Todd A.
背景和目的美国国家卫生统计中心是疾病控制中心的一部分，负责进行持续的公共卫生监测活动。美国武装部队还拥有一个全面的医疗信息数据库。我们的目的是从这些国家政府调查中确定美国成年平民和现役军人中偏头痛和严重头痛的最新患病率估计值，以评估患病率估计值随时间的稳定性，并确定与偏头痛和其他严重头痛疾病的负担和治疗相关的其他信息。全国门诊医疗调查、全国医院门诊医疗调查和全国健康访谈调查（NHIS）。还获得了来自国防医疗监督系统的汇总数据，并在PubMed中检索了基于这些研究报告汇总统计的出版物。对数据进行抽象、仔细检查其准确性，并总结不同时间段和人口统计变量的函数。结果2012年NHIS中，14.2%的18岁或以上美国成年人报告在过去3个月内患有偏头痛或严重头痛。女性偏头痛的总体年龄调整后3个月患病率为19.1%，男性为9.0%，但根据年龄差异很大。偏头痛的患病率在18-44岁的女性中最高，其中偏头痛或严重头痛的3个月患病率为23.5%。在2005-2012年期间，偏头痛或严重头痛的3个月患病率保持相对稳定，女性平均患病率为20.2%，男性为9.4%，总体为20.2%。在此期间，偏头痛或严重头痛的平均女性与男性的性别比例为2.17。1998年至2010年，美国现役军人偏头痛的未校正1年患病率为1%至1.9%，男性为0.7%至1.2%，女性为3.5%至6%。该军事人群中其他头痛的1年患病率范围从2003年的1.9%降至2010年的3%。头痛或头部疼痛是2009-2010年急诊科（艾德）就诊的第四大原因，占所有艾德就诊的3.1%。在所有的门诊治疗中，偏头痛占所有就诊的0.5%，其他头痛占所有门诊治疗的0.4%。52.8%的偏头痛就诊发生在初级保健机构，23.2%发生在专科门诊机构，16.7%发生在急诊室。在2010年，阿片类药物管理在35%的艾德访问头痛，而曲坦类药物管理只有1.5%的visits.ConclusionsThis报告总结了最近的政府统计数据偏头痛和严重头痛的患病率和负担在美国平民和现役军人。偏头痛的患病率很高，每年大约每7个美国人中就有1个受到影响，并且在过去8年中保持相对稳定。偏头痛和头痛是门诊和艾德就诊的主要原因，仍然是一个重要的公共卫生问题，特别是在育龄妇女中。
Background and ObjectivesThe US National Center for Health Statistics, which is part of the Centers for Disease Control, conducts ongoing public health surveillance activities. The US Armed Forces also maintains a comprehensive database of medical information. We aimed to identify the most current prevalence estimates of migraine and severe headache in the United States adult civilian and active duty service populations from these national government surveys, to assess stability of prevalence estimates over time, and to identify additional information pertinent to the burden and treatment of migraine and other severe headache conditions.MethodsWe searched for the most current publicly available summary statistics from the National Ambulatory Medical Care Survey, the National Hospital Ambulatory Medical Care Survey, and the National Health Interview Survey (NHIS). Summary data from the Defense Medical Surveillance System were also obtained, and PubMed was also searched for publications reporting summary statistics based on these studies. Data were abstracted, double-checked for accuracy, and summarized over time periods and as a function of demographic variables.Results14.2% of US adults 18 or older reported having migraine or severe headache in the previous 3 months in the 2012 NHIS. The overall age-adjusted 3-month prevalence of migraine in females was 19.1% and in males 9.0%, but varied substantially depending on age. The prevalence of migraine was highest in females 18-44, where the 3-month prevalence of migraine or severe headache was 23.5%. The 3-month prevalence of migraine or severe headache has remained relatively stable over the period of 2005-2012, with an average prevalence of 20.2% in females, 9.4% in males, and 20.2% overall. During this time, the average female to male sex ratio for migraine or severe headache was 2.17. The unadjusted 1-year prevalence of migraine in active duty US military service members varied from 1% to 1.9% between 1998 and 2010, ranging from 0.7% to 1.2% in males and 3.5% to 6% in females. The 1-year prevalence of other headache in this military population ranged from a low of 1.9% in 2003 to a high of 3% in 2010. Headache or pain in the head was the fourth leading cause of visits to the emergency department (ED) in 2009-2010, accounting for 3.1% of all ED visits. Across all ambulatory care settings, migraine accounted for 0.5% of all visits and other headache presentations for 0.4% of all ambulatory care visits. 52.8% of all visits for migraine occurred in primary care settings, 23.2% in specialty outpatient settings, and 16.7% in EDs. In 2010, opioids were administered at 35% of ED visits for headache, while triptans were administered in only 1.5% of visits.ConclusionsThis report summarizes the most recent government statistics on the prevalence and burden of migraine and severe headache in the US civilian and active duty military populations. The prevalence of migraine headaches is high, affecting roughly 1 out of every 7 Americans annually, and has remained relatively stable over the last 8 years. Migraine and headache are leading causes of outpatient and ED visits and remain an important public health problem, particularly among women during their reproductive years.