Ljunggren Micaela, Persson Julia, Salzer Jonatan
Eur Neurol. 2018;79(1-2):5-12. doi: 10.1159/000481982. Epub 2017 Nov 13.
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.
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.
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.
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.
头晕是急诊科常见的症状。本研究旨在描述于乌梅奥大学医院急诊科就诊的伴有或不伴有急性前庭综合征（AVS）的头晕患者的流行病学特征及治疗情况。
共确定了3年内2126例急诊科头晕就诊病例。数据通过回顾病历获得。病例根据临床表现进行分层，包括AVS和神经功能缺损。分析的结果包括头晕的脑血管病因。计算发病率置信区间时采用泊松分布。
头晕占所有急诊科就诊病例的2.1%，发病率为477/10万居民（95%置信区间457 - 498）。在头晕患者中，19.2%患有AVS，发病率为92/10万居民（95%置信区间74 - 113）。主要的医学诊断类别为耳前庭疾病（15.1%）、心血管疾病（8.7%）和神经疾病（7.7%），包括中风和短暂性脑缺血发作（4.8%）。伴有AVS的患者中头晕的脑血管病因（10.0%）比不伴有AVS的患者（3.6%）更常见，p < 0.01。
头晕的脑血管病因风险，尽管在未筛选的队列中较低，但随着神经体征和AVS的出现而增加。这些基于人群的数据在急诊科规划和实施头晕及AVS治疗方案时可能有用。
