AVANI-ER Scoring System Has High Diagnostic Performance in Headache Patients

Background: Headache is a frequent emergency department (ED) presentation, and neuroimaging is often obtained to distinguish benign primary headaches from those with serious secondary causes. While clinical “red flag” signs have been proposed as predictors of abnormal imaging, their validation has been inconclusive. Objective: To identify clinical predictors of abnormal neuroimaging in ED patients with headache, and to develop and validate a reliable scoring system (Associated Variables with Abnormal Neuroimaging in patients with headache at Emergency Room [AVANI-ER]) for clinical use. Design: Retrospective single-center study. Methods: The study was conducted for 8 years, 11 months at a tertiary care teaching hospital in Cali, Colombia. Adult patients with nontraumatic headache who underwent neuroimaging were included. Demographic, clinical, and imaging data were collected. Overall, 3 predictive models were evaluated: Model 1 – Variables with P <0.20 and odds ratio of >1.8 fro more...