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European Archives of Oto-Rhino-Laryngology

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Open Access 01-09-2019 | Magnetic Resonance Imaging | Otology

Effectiveness of care in acute dizziness presentations

Authors: Mikael Granberg Sandlund, Anna Diamant, Gabriel Granåsen, Jonatan Salzer

Published in: European Archives of Oto-Rhino-Laryngology | Issue 9/2019

Abstract

Purpose

This study aims to evaluate whether a management algorithm has improved the effectiveness of care for dizzy patients at Umeå University Hospital.

Methods

This was an interventional study using medical records to collect data for acute dizziness presentations before (period 1, 2012–2014) and after (period 2, 2016–2017) the implementation of a management algorithm. Outcomes were changes in a set of pre-defined effectiveness markers and health economic effects.

Results

Total n = 2126 and n = 1487 acute dizziness presentations were identified in period 1 and 2, respectively. Baseline characteristics were similar. The proportion of patients undergoing Dix–Hallpike testing increased, 20.8% [95% confidence interval (CI) 18.8–23.0%] vs. 37.7% (95% CI 35.2–40.2%), as did BPPV diagnoses, 7.6% (95% CI 6.6–8.8%) vs. 15.3% (95% CI 13.6–17.3%). Hospitalization became less common, 61.5% (95% CI 59.4–63.6%) vs. 47.6% (95% CI 45.1–50.2%). The proportion undergoing any neuroradiological investigation decreased, 44.8% (95% CI 42.7–47.0%) vs. 36.3% (95% CI 33.8–38.7%) with a shift from CT to MRI, with unchanged sensitivity for diagnosing cerebrovascular causes. The average cost for the care of one dizzy patient decreased from $2561 during period 1 to $1808 during period 2.

Conclusions

This study shows that the implementation of a management algorithm for dizzy patients was associated with improved effectiveness of care.

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Title: Effectiveness of care in acute dizziness presentations
Authors: Mikael Granberg Sandlund
Anna Diamant
Gabriel Granåsen
Jonatan Salzer
Publication date: 01-09-2019
Publisher: Springer Berlin Heidelberg
Keywords: Magnetic Resonance Imaging
Magnetic Resonance Imaging
Stroke
Benign Paroxysmal Positional Vertigo
Care
Computed Tomography
Computed Tomography
Published in: European Archives of Oto-Rhino-Laryngology / Issue 9/2019
Print ISSN: 0937-4477
Electronic ISSN: 1434-4726
DOI: https://doi.org/10.1007/s00405-019-05470-0

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Effectiveness of care in acute dizziness presentations

Abstract

Purpose

Methods

Results

Conclusions

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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