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European Archives of Oto-Rhino-Laryngology

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01-07-2018 | Otology

Identification of dizzy patients who will develop an acute cerebrovascular syndrome: a descriptive study among emergency department patients

Authors: I. Mármol-Szombathy, E. Domínguez-Durán, L. Calero-Ramos, S. Sánchez-Gómez

Published in: European Archives of Oto-Rhino-Laryngology | Issue 7/2018

Abstract

Purpose

To calculate the incidence of subsequent acute cerebrovascular syndrome in emergency department patients with vertigo or dizziness symptoms and to determine predictors of subsequent acute cerebrovascular syndrome in these patients.

Methods

Descriptive and retrospective hospital based-population study among emergency department patients with vertigo or dizziness symptoms in 1 year. One year follow-up since the medical visit was performed. Chi-square and Fisher tests were used for qualitative variables; Mann–Whitney U test for quantitative variables. A multivariate model was created.

Results

1243 dizzy patients who visited emergency department during 2015 were identified, finally 928 were included. 12 acute cerebrovascular syndromes were identified; 8 strokes and 4 transient ischemic attacks. Percentages over the sample size: 1.29% for acute cerebrovascular syndromes, 0.43% for transient ischemic attack and 0.86% for stroke. Odds ratio values to develop an event over the general population were 7.24 for acute cerebrovascular syndrome, 95% CI (3.98–13.12); 14.9 for transient ischemic attack, 95% CI (4.8–40.9) and 5.86 for stroke, 95% CI (2.72–12.0). Atrial fibrillation and diabetes mellitus were identified as significant risk factors to develop an acute cerebrovascular syndrome.

Conclusion

Emergency department patients with symptoms of vertigo or dizziness had sevenfold higher risk of acute cerebrovascular syndromes than the general population. Atrial fibrillation and diabetes mellitus are risk factors associated with high risk of acute cerebrovascular syndromes in these patients.

Bisdorf A, Von Brevern M, Lempert T et al (2009) Classification of vestibular symptoms: towards an international classification of vestibular disorders. J Vestibul Res 19:1–13

Bisdorff A, Bosser G, Gueguen R et al (2013) The epidemiology of vertigo, dizziness, and unsteadiness and its links to co-morbidities. Front Neurol 4:29CrossRefPubMedPubMedCentral

Lammers W, Folmer W, Van Lieshout EM et al (2011) Demographic analysis of emergency department patients at the Ruijin Hospital, Shanghai. Emerg Med Int 2011:748274CrossRefPubMedPubMedCentral

Shahrami A, Norouzi M, Kariman H, Hatamabadi HR et al (2016) True vertigo patients in Emergency Department; an epidemiologic study. Emerg (Tehran) 4(1):25–28

Kerber KA et al (2009) Vertigo and dizziness in the Emergency Department. Emerg Med Clin North Am 27(1):39–50CrossRefPubMedPubMedCentral

Kim DR, Lee HJ, Kim HJ et al (2011) Dynamic changes in the inner ear function and vestibular neural pathway related to the progression of labyrinthine infarction in patient with an anterior inferior cerebellar artery infarction. Otol Neurotol 32:1596–1599CrossRefPubMed

Lee CC, Ho HH, Su YC et al (2012) Increased risk of vascular events in emergency room patients discharged home with a diagnosis of dizziness or vertigo: a 3 year follow-up study. PLoS One 7(4):e35923CrossRefPubMedPubMedCentral

Kerber KA, Brown DL, Lisabeth LD, Smith MA, Morgenstern LB (2006) Stroke among patients with dizziness, vertigo, and imbalance in the emergency department: a population-based study. Stroke 37:2484–2487CrossRefPubMedPubMedCentral

Kim AS, Fullerton HJ, Johnston SC (2011) Risk of vascular events in emergency department patients discharged home with diagnosis of dizziness or vertigo. Ann Emerg Med 57:34–41CrossRefPubMed

10.

Díaz-Guzmán J, Egido-Herrero JA, Fuentes B et al (2012) Stroke and transient ischemic attack incidence rate in Spain: the IBERICTUS study. Cerebrovasc Dis 34(4):272–281CrossRefPubMed

11.

Kerber KA, Newman-Toker DE (2015) Misdiagnosing dizzy patients: common pitfalls in clinical practice. Neurol Clin 33:564–576CrossRef

12.

Savitz SI, Caplan LR, Edlow JA (2007) Pitfalls in the diagnosis of cerebellar infarction. Acad Emerg Med 14:63–68CrossRefPubMed

13.

Tohgi H, Takahashi S, Chiba K, Tohoku Cerebellar Infarction Study Group et al (1993) Cerebellar infarction. Clinical and neuroimaging analysis in 293 patients. Stroke 24:1697–1701CrossRefPubMed

Title: Identification of dizzy patients who will develop an acute cerebrovascular syndrome: a descriptive study among emergency department patients
Authors: I. Mármol-Szombathy
E. Domínguez-Durán
L. Calero-Ramos
S. Sánchez-Gómez
Publication date: 01-07-2018
Publisher: Springer Berlin Heidelberg
Published in: European Archives of Oto-Rhino-Laryngology / Issue 7/2018
Print ISSN: 0937-4477
Electronic ISSN: 1434-4726
DOI: https://doi.org/10.1007/s00405-018-4988-2

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Identification of dizzy patients who will develop an acute cerebrovascular syndrome: a descriptive study among emergency department patients

Abstract

Purpose

Methods

Results

Conclusion

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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