Long-term outcome of vertigo and dizziness associated disorders following treatment in specialized tertiary care: the Dizziness and Vertigo Registry (DiVeR) Study
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To investigate the long-term outcome of interdisciplinary treatment in a tertiary care neuro-otology institution after 2 years as part of the Dizziness and Vertigo Registry study. Risk factors associated with unfavourable outcome were assessed. 3113 consecutive patients with disorders of vertigo and dizziness were recruited prospectively between March 2010 and February 2012. Patients were clinically assessed and treated according to their diagnosis. Standardized instruments were used at baseline and at 2-year follow-up [Dizziness Handicap Inventory (DHI), Quality of Life Questionnaire, General Depression Scale, Stait-Trait Anxiety Index], as well as a custom health-related questionnaire. The primary outcome variable of this observational study was the change in DHI after 2 years. Patients suffered from phobic postural vertigo (23 %), benign peripheral paroxysmal vertigo (14.4 %), unilateral vestibulopathy (10.5 %), central vestibular disorders (8 %), Menière’s disease (9.8 %), vestibular migraine (6.9 %), bilateral vestibulopathy (5.5 %), and vestibular paroxysmia (3.1 %). Mean disease duration was 4.6 ± 6.3 years. 1272 patients were available for follow-up, 1159 completed the DHI score. 72.1 % of patients improved in DHI score from baseline to 2 years follow-up. Mean reduction in DHI score was 14 points (p = 0.02). Long-term outcome following diagnosis and treatment in a specialized tertiary care centre is good and persistent after 2 years. Risk factors for an unfavourable outcome were advanced age, severe disability, constant vertigo or dizziness, and concomitant back pain, while depression and anxiety did not contribute to this risk considerably.
KeywordsTertiary care Dizziness Vertigo Treatment centre Long-term follow-up
We would like to thank Prof. Thomas Brandt for his valuable input, revision, and constructive criticism of this manuscript.
Conflicts of interest
Mark Obermann has received scientific support and/or honoraria from Biogen Idec, Novartis, Sanofi-Aventis, Genzyme, Pfizer, Teva and Heel. He received research grants from Allergan, Electrocore, Heel, and the German Ministry for Education and Research (BMBF). Eva Bock has nothing to disclose. Nikolay Sabev has nothing to disclose. Nils Lehmann has nothing to disclose. Ralph Weber received honoria for oral presentations from Boehringer Ingelheim. Bristol-Myers Squibb and Covidien. Marcus Gerwig has nothing to disclose. Markus Frings has nothing to disclose. Diana Arweiler-Harbeck has nothing to disclose. Stephan Lang has nothing to disclose. Hans-Christoph Diener has received honoraria for participation in clinical trials, contribution to advisory boards or lectures from Addex Pharma, Allergan, Almirall, AstraZeneca, Bayer Vital, Berlin Chemie, Coherex Medical, CoLucid, Böhringer Ingelheim, Bristol-Myers Squibb, GlaxoSmithKline, Grünenthal, Janssen-Cilag, Lilly, La Roche, 3 M Medica, Minster, MSD, Novartis, Johnson & Johnson, Pierre Fabre, Pfizer, Schaper and Brümmer, SanofiAventis, and Weber & Weber; received research support from Allergan, Almirall, AstraZeneca, Bayer, Galaxo-Smith-Kline, Janssen-Cilag, and Pfizer. Research at the Department of Neurology in Essen is supported by the German Research Council (DFG), the German Ministry of Education and Research (BMBF), and the European Union.
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