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Abstract

Introduction: Trigeminal neuralgia (TN) is a frequent cause of paroxysmal severe facial pain and headache in adults. The incidence of TN is thought to increase with age, with an annual incidence of 4 to 13 per 100,000 people in prior studies. Over the past several decades the average life expectancy in United States has gradually increased. Current national estimates and outcomes associated with trigeminal neuralgia necessitating emergency care are lacking. Methods: We performed a retrospective analysis of the Nationwide Emergency Department Sample for the years 2008 to 2010. All hospital based emergency departments (ED) with a diagnosis of trigeminal neuralgia (ICD-9-CM code 350.1) were selected. Patient and hospital related characteristics were examined. Descriptive statistics were used to summarize the data. Each individual ED visit was the unit of analysis. The discharge weight variable for each ED visit was used to project to nationally representative estimates. Outcomes examined included disposition information following ED visit, and hospital ED charges. Results: During the study period, a total of 132,824 ED visits presented with trigeminal neuralgia. The mean age of these ED visits was 61.6 years. Females comprised 71.4% of all ED visits. Medicare was the major payer covering 52.4% of all ED visits. Thirty five patients died in the ED. Following ED visit, 54.3% were discharged routinely, 43.3% were admitted as inpatients into the same hospital, and 0.7% were transferred to another short term hospital. About 37% of all ED visits also had a co-morbid condition. The mean ED charge (inflation adjusted to year 2010) per visit was $2,257 and the total ED charges across the entire United States was $239 million. Conclusions: Trigeminal neuralgia is not an infrequent cause of emergency department visits in United States. Females and those in the 6th decade of life constitute the majority of visits. Hospital resource utilization is significant.