Incidence of Status Migrainosus in Olmsted County, Minnesota, United States: Characterization and Predictors of Recurrence.


Journal

Neurology
ISSN: 1526-632X
Titre abrégé: Neurology
Pays: United States
ID NLM: 0401060

Informations de publication

Date de publication:
17 01 2023
Historique:
received: 23 05 2022
accepted: 24 08 2022
pmc-release: 17 01 2024
pubmed: 30 9 2022
medline: 19 1 2023
entrez: 29 9 2022
Statut: ppublish

Résumé

SM is recognized as a complication of migraine in which pain and/or associated symptoms are unremitting and debilitating for more than 72 hours. The epidemiology of SM in the general population is not known. The aim of this study is to determine the incidence, recurrence rate, and clinical associations of status migrainosus (SM) in care-seeking residents of Olmsted County, Minnesota. The Rochester Epidemiology Project was used to identify the incident cases of SM according to the Between January 1, 2012, and December 31, 2017, 237 incident cases of SM were identified. The median age was 35 (IQR 26-47) years, and 210 (88.6%) were female. A history of chronic migraine was recorded in 82/226 (36.3%) and a history of aura in 76/213 (35.7%). At the time of the incident case, medication reconciliation included a triptan or ergotamine in 127/233 (53.6%) and/or an opioid-containing analgesic in 43/233 (18.5%). The overall age- and sex-adjusted incidence rate was 26.60 per 100,000 [95% CI, 23.21-29.97], with a peak incidence between ages 40 and 49 years. The median (95% CI) attack duration was 5 (4.48-5.42) days. The most frequent triggers were stress (40/237, 16.9%) and too much or too little sleep (27/237, 11.4%). Recurrence occurred in 35/237 (14.8%) at a median of 58 (IQR 23-130) days following the initial attack. In our age- and sex-adjusted multivariable model, too much or too little sleep as a trigger was associated with 12-month risk of recurrence (adjusted OR 3.59 [95% CI 1.58-8.14], Our study provides a population-based estimate of SM incidence. We identified aberrant sleep patterns as a potentially modifiable risk factor for 1-year SM recurrence.

Sections du résumé

BACKGROUND AND OBJECTIVES
SM is recognized as a complication of migraine in which pain and/or associated symptoms are unremitting and debilitating for more than 72 hours. The epidemiology of SM in the general population is not known. The aim of this study is to determine the incidence, recurrence rate, and clinical associations of status migrainosus (SM) in care-seeking residents of Olmsted County, Minnesota.
METHODS
The Rochester Epidemiology Project was used to identify the incident cases of SM according to the
RESULTS
Between January 1, 2012, and December 31, 2017, 237 incident cases of SM were identified. The median age was 35 (IQR 26-47) years, and 210 (88.6%) were female. A history of chronic migraine was recorded in 82/226 (36.3%) and a history of aura in 76/213 (35.7%). At the time of the incident case, medication reconciliation included a triptan or ergotamine in 127/233 (53.6%) and/or an opioid-containing analgesic in 43/233 (18.5%). The overall age- and sex-adjusted incidence rate was 26.60 per 100,000 [95% CI, 23.21-29.97], with a peak incidence between ages 40 and 49 years. The median (95% CI) attack duration was 5 (4.48-5.42) days. The most frequent triggers were stress (40/237, 16.9%) and too much or too little sleep (27/237, 11.4%). Recurrence occurred in 35/237 (14.8%) at a median of 58 (IQR 23-130) days following the initial attack. In our age- and sex-adjusted multivariable model, too much or too little sleep as a trigger was associated with 12-month risk of recurrence (adjusted OR 3.59 [95% CI 1.58-8.14],
DISCUSSION
Our study provides a population-based estimate of SM incidence. We identified aberrant sleep patterns as a potentially modifiable risk factor for 1-year SM recurrence.

Identifiants

pubmed: 36175145
pii: WNL.0000000000201382
doi: 10.1212/WNL.0000000000201382
pmc: PMC10615570
doi:

Substances chimiques

Analgesics, Opioid 0

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

e255-e263

Subventions

Organisme : NIA NIH HHS
ID : R33 AG058738
Pays : United States

Informations de copyright

© 2022 American Academy of Neurology.

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Auteurs

Juliana H VanderPluym (JH)

From the Departments of Neurology (J.H.V., K.M., A.A.M., D.G., R.B.H.S., J.H.S.) and Quantitative Health Sciences (R.J.B.), Mayo Clinic, Scottsdale, AZ; and Neurology Department (E.C.), Hospital Universitari Vall d'Hebron, Barcelona, Spain. vanderpluym.juliana@mayo.edu.

Kartik Mangipudi (K)

From the Departments of Neurology (J.H.V., K.M., A.A.M., D.G., R.B.H.S., J.H.S.) and Quantitative Health Sciences (R.J.B.), Mayo Clinic, Scottsdale, AZ; and Neurology Department (E.C.), Hospital Universitari Vall d'Hebron, Barcelona, Spain.

Amir Abdallah Mbonde (AA)

From the Departments of Neurology (J.H.V., K.M., A.A.M., D.G., R.B.H.S., J.H.S.) and Quantitative Health Sciences (R.J.B.), Mayo Clinic, Scottsdale, AZ; and Neurology Department (E.C.), Hospital Universitari Vall d'Hebron, Barcelona, Spain.

David Gritsch (D)

From the Departments of Neurology (J.H.V., K.M., A.A.M., D.G., R.B.H.S., J.H.S.) and Quantitative Health Sciences (R.J.B.), Mayo Clinic, Scottsdale, AZ; and Neurology Department (E.C.), Hospital Universitari Vall d'Hebron, Barcelona, Spain.

Edoardo Caronna (E)

From the Departments of Neurology (J.H.V., K.M., A.A.M., D.G., R.B.H.S., J.H.S.) and Quantitative Health Sciences (R.J.B.), Mayo Clinic, Scottsdale, AZ; and Neurology Department (E.C.), Hospital Universitari Vall d'Hebron, Barcelona, Spain.

Rashmi B Halker Singh (RB)

From the Departments of Neurology (J.H.V., K.M., A.A.M., D.G., R.B.H.S., J.H.S.) and Quantitative Health Sciences (R.J.B.), Mayo Clinic, Scottsdale, AZ; and Neurology Department (E.C.), Hospital Universitari Vall d'Hebron, Barcelona, Spain.

Richard J Butterfield (RJ)

From the Departments of Neurology (J.H.V., K.M., A.A.M., D.G., R.B.H.S., J.H.S.) and Quantitative Health Sciences (R.J.B.), Mayo Clinic, Scottsdale, AZ; and Neurology Department (E.C.), Hospital Universitari Vall d'Hebron, Barcelona, Spain.

Jonathan H Smith (JH)

From the Departments of Neurology (J.H.V., K.M., A.A.M., D.G., R.B.H.S., J.H.S.) and Quantitative Health Sciences (R.J.B.), Mayo Clinic, Scottsdale, AZ; and Neurology Department (E.C.), Hospital Universitari Vall d'Hebron, Barcelona, Spain.

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