True Vertigo Patients in Emergency Department; an Epidemiologic Study
Archives of Academic Emergency Medicine,
Vol. 4 No. 1 (2016),
1 February 2016
,
Page 25-28
https://doi.org/10.22037/aaem.v4i1.212
Abstract
Introduction: Vertigo prevalence is estimated to be 1.8% among young adults and more than 30% in the elderly. 13-38% of the referrals of patients over 65 years old in America are due to vertigo. Vertigo does not increase the risk of mortality but it can affect the patient’s quality of life. Therefore, this study was designed to evaluate the epidemiologic characteristics of vertigo patients referred to the emergency department (ED). Methods: In this 6-month retrospective cross-sectional study, the profiles of all vertigo patients referred to the ED of Imam Hossein Hospital, Tehran, Iran, from October 2013 to March 2014 were evaluated. Demographic data and baseline characteristics of the patients were recorded and then patients were divided into central and peripheral vertigo. The correlation of history and clinical examination with vertigo type was evaluated and screening performance characteristics of history and clinical examination in differentiating central and peripheral vertigo were determined. Results: 379 patients with the mean age of 50.69 ± 11.94 years (minimum 18 and maximum 86) were enrolled (58.13% female). There was no sex difference in vertigo incidence (p = 0.756). A significant correlation existed between older age and increase in frequency of central cases (p < 0.001). No significant difference was detected between the treatment protocols regarding ED length of stay (p = 0.72). There was a significant overlap between the initial diagnosis and the final decision based on imaging and neurologist’s final opinion (p < 0.001). In the end, 361 (95.3%) patients were discharged from ED, while 18 were disposed to the neurology ward. No case of mortality was reported. Conclusion: Sensitivity and specificity of history and clinical examination in differentiating central and peripheral vertigo were 99 (95% CI: 57-99) and 99 (95% CI: 97-99), respectively.- Vertigo
- epidemiology
- mass screening
- emergency department
How to Cite
References
Sloane PD, Coeytaux RR, Beck RS, Dallara J. Dizziness: state of the science. Ann Intern Med. 2001;134(9_Part_2):823-32.
Reid SA, Rivett DA. Manual therapy treatment of cervicogenic dizziness: a systematic review. Man Ther. 2005;10(1):4-13.
Sloane P. Dizziness in primary care. Results from the national ambulatory medical care survey. J Fam Pract. 1989;29(1):33-8.
Nakashima K, Yokoyama Y, Shimoyama R, et al. Prevalence of neurological disorders in a Japanese town. Neuroepidemiology. 1996;15(4):208-13.
Moulin T, Sablot D, Vidry E, et al. Impact of emergency room neurologists on patient management and outcome. Eur Neurol. 2002;50(4):207-14.
Kroenke K, Spitzer RL, Hahn SR, et al. Multisomatoform disorder: an alternative to undifferentiated somatoform disorder for the somatizing patient in primary care. Arch Gen Psychiatry. 1997;54(4):352-8.
Strain G, Myers L. Hearing and equilibrium. In: Reece W, editor. Dukes' physiology of domestic animals. 12 ed. United Kingdom: CAB Direct; 2004. p. 852-64.
Braunwald E, Fauci AS, Kasper DL, et al. Faintness, syncope, dizziness, and vertigo. Harrison's Principles of Internal Medicine. 1. Bahman: McGraw-Hill Professional Publishing; 2001. p. 111-8.
Parfitt K, Martindale W. The complete drug reference. London: Pharmaceutical Press; 1999. p. 51.
Cohen HS, Kimball KT. Increased independence and decreased vertigo after vestibular rehabilitation. Otolaryngol Head Neck Surg. 2003;128(1):60-70.
Karatas M. Central vertigo and dizziness: epidemiology, differential diagnosis, and common causes. Neurologist. 2008;14(6):355-64.
Değerli V, Çevik AA, Türkçüer i. Comparison of Intraveneous Diazepam, Dimenhydrinate and Diphenhydramine on Patients with Acute Peripheral Vertigo in the Emergency Department: A Randomized, Double Blind, Clinical Trial. Turk J Emerg Med. 2007;7(1):10-7.
Izadi P, Yarmohammadi ME, Afshinmajd S, et al. Effect of dimenhydrinate on benign paroxysmal positional vertigo. Razi J Med Sci. 2011;18(86):12-21.
Dashti-Khadivaki G, Absalan A, Boroumand P. Therapeutic effect of Epley maneuver on patients with posterior semicircular canal in benign paroxysmal positional vertigo. Zahedan J Res Med Sci. 2010;12(2):36-9. [Persian].
Ebadi H, Borgheie A, Mali M, Talebi M, Rabiei MR. Comparison Between the Effectiveness of Physical Maneauer and Medicinal Therapy in the Treatment of Benign Paroxysmal Positional Vertigo. J Mazandaran Uni Med Sci. 2007;17(58):1-8. [Persian].
Yin M, Ishikawa K, Wong WH, Shibata Y. A clinical epidemiological study in 2169 patients with vertigo. Auris Nasus Larynx. 2009;36(1):30-5.
Gananca MM, Caovilla HH, Munhoz MS, et al. Optimizing the pharmacological component of integrated balance therapy. Braz J Otorhinolaryngol. 2007;73(1):12-8.
Nuti D, Nati C, Passali D. Treatment of benign paroxysmal positional vertigo: no need for postmaneuver restrictions. Otolaryngol Head Neck Surg. 2000;122(3):440-4.
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