Kim Maru, Lee Dae-Sang, Hong Tae Hwa, Joo Cho Hang
Department of Trauma Surgery, Ujeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
Medicine (Baltimore). 2018 Dec;97(49):e13150. doi: 10.1097/MD.0000000000013150.
Benign paroxysmal positional vertigo (BPPV) is a comorbid condition prevalent in patients recovering from trauma. Due to the paucity of studies investigating the etiology of this condition, the present study sought to analyze the high-risk group of BPPV patients following trauma.Trauma patients visiting the emergency department from January to December 2016 were enrolled. The study excluded patients with minor superficial injuries, those who were dead, and those discharged within 2 days after their visit. The medical records were reviewed, and every abbreviated injury score, injury severity score, and other clinical characteristics, such as age and sex, were gathered. A diagnosis of BPPV was reached only after a provocation test was administered by an otolaryngologist. The correlation was statistically analyzed.A total of 2219 trauma patients were analyzed. The mean age of the patients was 52.6 years, and the mean injury severity score (ISS) was 7.9. About 70% of the patients were men. Additional BPPV patients were identified among patients with injuries to head and neck, chest, and abdomen, and those with external injuries. However, patients with head and neck (odds ratio [OR] (95% confidence interval [CI]) = 10.556 (1.029-108.262), and abdominal injury (OR [95% CI] = 78.576 [1.263-4888.523]) showed statistically significant correlation with BPPV in the logistic regression analysis. Patients-not only those with head and neck injuries but those with abdominal injuries-who complain of dizziness need to be evaluated for BPPV using provocation tests. Further studies investigating traumatic BPPV are needed.
良性阵发性位置性眩晕(BPPV)是创伤后恢复患者中普遍存在的一种合并症。由于研究该疾病病因的研究较少,本研究旨在分析创伤后BPPV患者的高危人群。纳入了2016年1月至12月到急诊科就诊的创伤患者。该研究排除了轻度浅表损伤患者、死亡患者以及就诊后2天内出院的患者。查阅了病历,并收集了每个简略损伤评分、损伤严重程度评分以及其他临床特征,如年龄和性别。只有在耳鼻喉科医生进行激发试验后才做出BPPV的诊断。进行了统计学相关性分析。共分析了2219例创伤患者。患者的平均年龄为52.6岁,平均损伤严重程度评分为7.9。约70%的患者为男性。在头部和颈部、胸部和腹部受伤以及有外伤的患者中发现了更多的BPPV患者。然而,在逻辑回归分析中,头部和颈部损伤患者(优势比[OR](95%置信区间[CI])=10.556(1.029 - 108.262))和腹部损伤患者(OR[95%CI]=78.576[1.263 - 4888.523])与BPPV显示出统计学上的显著相关性。主诉头晕的患者——不仅是头部和颈部受伤的患者,还有腹部受伤的患者——需要通过激发试验进行BPPV评估。需要进一步研究创伤性BPPV。