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Date of Presentation
5-7-2026
Document Type
Poster
Department
Medicine
Faculty Mentor
Alan Sazama, MD, University of South Dakota Sanford School of Medicine & Avera Health
Second Advisor
Benjamin Aaker, MD, University of South Dakota Sanford School of Medicine & Avera Health
Keywords
emergency room, rural healthcare, pain relief, hospital admission
Subject Categories
Anesthesia and Analgesia | Medicine and Health Sciences | Neurosciences | Rural Health | Therapeutics
Abstract
Evaluating Headache Treatment Efficacy Across Rural and Urban Emergency Departments
Logan Stacey, MD | Alan Sazama, MD, Benjamin Aaker, MD
Introduction: Headaches are a common chief complaint in emergency departments (EDs), with rural patients facing unique challenges such as geographic isolation and limited access to care. This study aims to compare treatment efficacy for this top five ED chief complaints between rural and urban EDs.
Methods: Patients treated for headaches from 2020-2023 were identified using diagnosis codes and electronic health records. Treatment plans and patient demographics were abstracted from identified charts. EDs were categorized as rural (populations under 50,000) or urban. Pain score before and after treatment were acquired and used to calculate pain score reduction. Paired t-tests and chi-square analysis were used to determine significance.
Results: A total of 13,375 patients were included (6,165 urban, 7,210 rural). Pain reduction was similar between urban (3.78) and rural EDs (3.61) (p = 0.094). Urban EDs had longer length of stay (2.95 hours vs. 2.60 hours in rural EDs, p < 0.0001). Medication use varied: opioids were more frequently used in rural EDs (8.3% vs. 3.6%), while NSAIDs and acetaminophen showed similar use across both settings (p< 0.0001). Route of medication was significantly different across EDs (p< 0.0001). Demographics differed slightly with a higher percentage of Native American patients in rural EDs (10% vs. 5.5% urban).
Conclusions: Treatment efficacy for headaches did not differ significantly between urban and rural EDs. Rural patients spent less time in ED, likely due to lower patient volume, and opioid use was higher in rural locations along with use of intramuscular medications.
Recommended Citation
Stacey, Logan; Sazama, Alan; and Aaker, Benjamin, "Evaluating Headache Treatment Efficacy Across Rural and Urban Emergency Departments" (2026). Scholarship Pathways Program. 30.
https://red.library.usd.edu/spp/30
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Anesthesia and Analgesia Commons, Neurosciences Commons, Rural Health Commons, Therapeutics Commons