Department of Otorhinolaryngology, Head and Neck Surgery, Solingen Municipal Hospital, Solingen.
Department of Otorhinolaryngology, Head and Neck Surgery, Ruhr University Bochum, St. Elisabeth-Hospital, Bochum.
Otol Neurotol. 2018 Apr;39(4):474-480. doi: 10.1097/MAO.0000000000001755.
The aim of this study was to analyze the prevalence of dizziness- and vertigo-related diagnoses in ear, nose, and throat (ENT) practices in Germany and the associated demographic characteristics based on data from a representative nationwide practice database.
The study sample included patients from 138 ENT practices in Germany who received dizziness- and vertigorelated diagnoses (ICD-10 code) between January 2012 and December 2015. Collected parameters included age, sex, insurance status, prescribed medication (anatomical therapeutic chemical [ATC] class), and referrals to other specialists and hospitals.
A total of 107,458 patients were available for analysis. Most common diagnoses were "dizziness and giddiness" (67.7%), "benign paroxysmal vertigo" (10.2%) and "disorder of vestibular function, unspecified" (7.2%). Referrals and admissions were made in 12.8%, mostly to radiologists (7.7%), followed by neurologists (3.7%), and hospitals (1.4%). Most referrals were made for unspecific diagnoses and for "vestibular neuronitis." The rate of medical prescriptions was 37.3%, with the most common prescription being for antivertigo preparations.
Dizziness- and vertigo-related disorders are frequently diagnosed in ENT practices in Germany. The majority of these diagnoses are unspecific and lead to an increased rate of referrals and hospital admissions. The medical prescription rate, especially of antivertigo preparations, was high, even among patients with benign paroxysmal positioning vertigo. This study reflects a mostly pragmatic approach to a complex diagnostic and therapeutic challenge in daily ENT practice as well as the limited ability of the ICD-10 system to classify the underlying etiology.
本研究旨在分析德国耳鼻喉科（ENT）实践中与头晕和眩晕相关的诊断的流行率，并基于代表性全国性实践数据库中的数据，分析其相关的人口统计学特征。
研究样本包括德国 138 家 ENT 诊所 2012 年 1 月至 2015 年 12 月间接受头晕和眩晕相关诊断（ICD-10 编码）的患者。收集的参数包括年龄、性别、保险状况、处方药物（解剖治疗化学[ATC]分类）以及转介给其他专家和医院的情况。
共 107458 例患者纳入分析。最常见的诊断是“头晕和眩晕”（67.7%）、“良性阵发性眩晕”（10.2%）和“前庭功能障碍，未特指”（7.2%）。转诊和住院率为 12.8%，主要转至放射科医生（7.7%）、神经科医生（3.7%）和医院（1.4%）。大多数转诊是针对未明确诊断和“前庭神经炎”。处方率为 37.3%，最常见的处方是抗眩晕制剂。
德国耳鼻喉科实践中经常诊断出头晕和眩晕相关疾病。这些诊断大多数不明确，导致转诊和住院率增加。尤其是对于良性阵发性位置性眩晕患者，处方药物的比例，尤其是抗眩晕制剂的比例较高。本研究反映了在日常 ENT 实践中，面对复杂的诊断和治疗挑战，一种主要以实用为导向的方法，以及 ICD-10 系统在对潜在病因进行分类方面的局限性。
