Department of Neurology, Inselspital, Bern University Hospital, University of Bern, Freiburgstrasse 10, 3010, Bern, Switzerland.
University Institute of Diagnostic and Interventional Neuroradiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
J Neurol. 2019 Dec;266(12):3076-3086. doi: 10.1007/s00415-019-09525-4. Epub 2019 Sep 17.
We aimed to determine the incidence of all vestibular symptoms in a large interdisciplinary tertiary emergency department (ED) and to assess stroke prevalence, and frequency of other life-threatening aetiologies.
In this 1-year retrospective study, we manually screened all medical records of 23,608 ED visits for descriptions of vestibular symptoms. Symptoms were classified according to the International Classification of Vestibular Disorders of the Bárány Society. We evaluated all patients older than 16 years in whom vestibular symptoms were the main or accompanying complaint. We extracted clinical, radiological, and laboratory findings as well as aetiologies from medical records.
We identified a total of 2596 visits by 2464 patients (11% of ED visits) who reported at least one vestibular symptom. In 1677/2596 visits (64.6%), vestibular symptoms were the main reason for the ED consultation. Vestibular symptoms were classified as dizziness (43.8%), vertigo (33.9%), postural symptoms (6.5%), or more than one symptom (15.8%). In 324/2596 visits (12.5%), cerebrovascular events were the aetiology of vestibular symptoms, and in 355/2596 visits (13.7%), no diagnosis could be established. In 23.8% of visits with vestibular symptoms as the main complaint, the underlying condition was life-threatening.
Frequency and impact of vestibular symptoms in patients visiting the ED were higher than previously reported, and life-threatening aetiologies such as strokes are common. Therefore, awareness among physicians regarding the importance of vestibular symptoms has to be improved.
我们旨在确定大型跨学科三级急诊部（ED）所有前庭症状的发生率，并评估中风的患病率以及其他危及生命病因的频率。
在这项为期 1 年的回顾性研究中，我们手动筛选了 23608 例 ED 就诊的所有病历，以查找前庭症状的描述。根据国际前庭疾病分类协会（Bárány Society）对症状进行分类。我们评估了所有年龄大于 16 岁且前庭症状为主诉或伴随症状的患者。我们从病历中提取了临床、放射学和实验室发现以及病因。
我们共确定了 2596 例由 2464 例患者（ED 就诊的 11%）就诊，这些患者报告了至少一种前庭症状。在 2596 例就诊中，有 1677 例（64.6%）就诊的主要原因是前庭症状。前庭症状分为头晕（43.8%）、眩晕（33.9%）、姿势症状（6.5%）或多种症状（15.8%）。在 324 例就诊中（12.5%），脑血管事件是前庭症状的病因，在 355 例就诊中（13.7%），未明确诊断。在以前庭症状为主要主诉的就诊中，有 23.8%的基础疾病危及生命。
ED 就诊患者的前庭症状频率和影响高于之前的报告，且常见危及生命的病因，如中风。因此，医生必须提高对前庭症状重要性的认识。
