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

  • Otology
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European Archives of Oto-Rhino-Laryngology Aims and scope Submit manuscript

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.

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References

  1. 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

    Google Scholar 

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

    Article  PubMed  PubMed Central  Google Scholar 

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

    Article  PubMed  PubMed Central  Google Scholar 

  4. 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

    Google Scholar 

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

    Article  PubMed  PubMed Central  Google Scholar 

  6. 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 32:1596–1599

    Article  PubMed  Google Scholar 

  7. 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):e35923

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  8. 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 37:2484–2487

    Article  PubMed  PubMed Central  Google Scholar 

  9. 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 57:34–41

    Article  PubMed  Google Scholar 

  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):272–281

    Article  PubMed  Google Scholar 

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

    Article  Google Scholar 

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

    Article  PubMed  Google Scholar 

  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 24:1697–1701

    Article  PubMed  CAS  Google Scholar 

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Funding

This study was not funded.

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Authors and Affiliations

  1. Department of Otolaryngology, University Hospital Virgen Macarena, Doctor Fedriani 3, 41009, Seville, Spain

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

Authors
  1. I. Mármol-Szombathy
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  2. E. Domínguez-Durán
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  3. L. Calero-Ramos
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  4. S. Sánchez-Gómez
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Corresponding author

Correspondence to I. Mármol-Szombathy.

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Conflict of interest

None of the authors had conflict of interest in relation with the study.

Ethical standards

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Mármol-Szombathy, I., Domínguez-Durán, E., Calero-Ramos, L. et al. Identification of dizzy patients who will develop an acute cerebrovascular syndrome: a descriptive study among emergency department patients. Eur Arch Otorhinolaryngol 275, 1709–1713 (2018). https://doi.org/10.1007/s00405-018-4988-2

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  • DOI: https://doi.org/10.1007/s00405-018-4988-2

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