Norwegian National Advisory Unit on Vestibular Disorders, Haukeland University Hospital, Bergen, Norway.
Department of Otorhinolaryngology, Head and Neck Surgery, Haukeland University Hospital, Bergen, Norway.
Laryngoscope. 2021 Jun;131(6):E2031-E2037. doi: 10.1002/lary.29465. Epub 2021 Feb 20.
To evaluate mortality among patients referred for suspected vestibular disorder and to examine whether specific symptoms or disorders predict long-term survival among patients with dizziness or vertigo.
Retrospective cohort study.
This retrospective cohort study analyzed long-term survival data. Consecutive patients examined for suspected vestibular disease at an otolaryngology clinic completed a detailed questionnaire regarding symptoms and comorbidities.
The study included 1,931 patients. Their mean age (standard deviation) was 50.5 (16.5) years, and 60% were women. The mean follow-up period was 20.6 years (range, 15.3-27.5 years). The standardized mortality ratio for the entire cohort compared with the Norwegian age- and sex-matched population was 1.03 (95% confidence interval [CI]: 0.94-1.12), illustrating no difference in overall survival. Patients with a cerebrovascular cause of dizziness had higher mortality in adjusted Cox regression analyses (hazard ratio [HR] 1.56, 95% CI: 1.11-2.19), whereas patients reporting periodic or short attacks of dizziness had lower mortality (HR 0.62 [0.50-0.77] and 0.76 [0.63-0.93], respectively). Reported unsteadiness between dizziness attacks was associated with higher mortality with an HR of 1.30 (95% CI: 1.08-1.57).
This long-term study found comparable mortality rates between patients evaluated for suspected vestibular disorder and that of the general population. However, subgroup analyses showed reduced mortality in patients with periodic or short attacks of dizziness and increased mortality in patients with unsteadiness between attacks or cerebrovascular causes of dizziness. The time course of vestibular symptoms should be determined, and thorough evaluation including fall risk and comorbidities must be considered in patients with nonepisodic symptoms.
3 Laryngoscope, 131:E2031-E2037, 2021.
评估因疑似前庭障碍就诊患者的死亡率，并研究头晕或眩晕患者的特定症状或疾病是否可预测其长期生存率。
回顾性队列研究。
本回顾性队列研究分析了长期生存数据。在耳鼻喉科诊所接受疑似前庭疾病检查的连续患者完成了一份详细的问卷，内容涉及症状和合并症。
该研究纳入 1931 例患者。其平均年龄（标准差）为 50.5（16.5）岁，60%为女性。平均随访时间为 20.6 年（范围，15.3-27.5 年）。与挪威年龄和性别匹配人群相比，整个队列的标准化死亡率比为 1.03（95%置信区间[CI]：0.94-1.12），表明总体生存率无差异。在调整后的 Cox 回归分析中，因脑血管原因导致头晕的患者死亡率更高（风险比[HR]1.56，95%CI：1.11-2.19），而报告周期性或短暂性头晕发作的患者死亡率更低（HR 分别为 0.62[0.50-0.77]和 0.76[0.63-0.93]）。报告头晕发作之间的不稳定与更高的死亡率相关，HR 为 1.30（95%CI：1.08-1.57）。
这项长期研究发现，疑似前庭障碍就诊患者的死亡率与普通人群相当。然而，亚组分析显示，周期性或短暂性头晕发作患者的死亡率降低，头晕发作之间不稳定或头晕由脑血管原因引起的患者死亡率升高。应确定前庭症状的时间过程，对于无阵发性症状的患者，必须考虑包括跌倒风险和合并症在内的全面评估。
3.《喉镜》，131：E2031-E2037，2021 年。
