Dizziness and the Acute Vestibular Syndrome at the Emergency Department: A Population-Based Descriptive Study

Abstract

Background: Dizziness is a common occurrence witnessed at emergency departments (EDs). This study aims to describe the epidemiology and management of dizzy patients with and without an acute vestibular syndrome (AVS) in the ED at Umeå University Hospital. Methods: A total of n = 2,126 ED dizziness visits during 3 years were identified. Data were obtained through retrospective review of medical records. Cases were stratified based on presentation, including AVS and neurological deficits. The outcomes analyzed included cerebrovascular causes of dizziness. A Poisson distribution was assumed when calculating incidence CIs. Results: Dizziness accounted for 2.1% of all ED visits, incidence 477/100,000 inhabitants (95% CI 457–498). Among dizzy patients, 19.2% had an AVS, incidence 92/100,000 inhabitants (95% CI 74–113). Top medical diagnostic groups were otovestibular (15.1%), cardiovascular (8.7%) and neurological diseases (7.7%), including stroke and transitory ischemic attack (4.8%). Cerebrovascular causes of dizziness were more common among those with an AVS (10.0%) vs. those without (3.6%), p < 0.01. Conclusion: The risk for cerebrovascular causes of dizziness, although low in an unselected cohort, increases with the presence of neurological signs and an AVS. These population-based data may be useful when planning and implementing dizziness and AVS management algorithms at EDs.

Prehospital Prediction of a Time-sensitive Condition Among Patients With Dizziness Assessed by the Emergency Medical Service&nbsp;

“…The last risk factor was increasing systolic blood pressure on the arrival of the EMS. This nding is in agreement with a number of previous studies [15,16,18,23]. The nding that an elevation of blood pressure is a risk factor for the development of a cerebrovascular disease is well documented [13,[25][26][27][28].…”

“…The observation that around six per cent of the patients with dizziness had a time-sensitive condition is also within the range that has previously been reported [13][14][15][16].…”

Causes of Dizziness Requiring Hospitalization in Emergency Department Patients: Five-Year Experiences of a Training Hospital

“…The rates of admission to the ED due to dizziness have been reported as 2.1-3.3%, consistent with the results of our study (8,12) . As is known, the decision of hospitalization of the patients with dizziness is affected by the healthcare quality of the ED and the bed capacity of the hospital.…”

Clinicopathologic Results in Meniere Disease: Evaluation of 80 patients

“…Meniere's disease is the second most common disease among all peripheral vestibular system diseases [5] . Although the first patient was reported by Prosper Meniere in 1861, the pathophysiology, clinicopathology and treatment of the disease have not been fully elucidated yet.…”