Department of Neurology, Seoul National University Bundang Hospital, Seongnam, South Korea.
Department of Neurology, Seoul National University College of Medicine, Seoul, South Korea.
Eur J Neurol. 2023 Jul;30(7):2062-2069. doi: 10.1111/ene.15543. Epub 2022 Sep 20.
The temporal characteristics of stroke risks were evaluated in emergency department patients who had a diagnosis of peripheral vertigo. It was also attempted to reveal the stroke risk factor amongst those with peripheral vertigo.
This is a parallel-group cohort study in a tertiary referral hospital. After assigning each of 4367 matched patients to the comparative set of peripheral vertigo and appendicitis-ureterolithiasis groups and each of 4911 matched patients to the comparative set of peripheral vertigo and ischaemic stroke groups, the relative stroke risk was evaluated. In addition, to predict the individual stroke risk in patients with peripheral vertigo, any association between the demographic factors and stroke events was evaluated in the peripheral vertigo group.
The peripheral vertigo group had a higher stroke risk than the appendicitis-ureterolithiasis group (hazard ratio 1.73, 95% confidence interval 1.18-2.55) but a lower risk than the ischaemic stroke group (hazard ratio 0.30, 95% confidence interval 0.24-0.37). The stroke risk of the peripheral vertigo group was just below that of small vessel stroke. The stroke risk of the peripheral vertigo group differed markedly by time: higher within 7 days, moderate between 7 days and 1 year, and diminished thereafter. Old age (>65 years), male gender and diabetes mellitus were the risk factors for stroke in the peripheral vertigo group.
Patients with a diagnosis of peripheral vertigo in the emergency department showed a moderate future stroke risk and so a stroke preventive strategy tailored to the timing of symptom onset and individual risk is required.
本研究评估了在被诊断为外周性眩晕的急诊科患者中，中风风险的时间特征。同时，还试图揭示外周性眩晕患者的中风危险因素。
这是一项在三级转诊医院进行的平行队列研究。将 4367 例匹配患者中的每一例分配到外周性眩晕和阑尾炎-输尿管结石组的对照组中，将 4911 例匹配患者中的每一例分配到外周性眩晕和缺血性中风组的对照组中，评估相对中风风险。此外，为了预测外周性眩晕患者的个体中风风险，在外周性眩晕组中评估了人口统计学因素与中风事件之间的任何关联。
外周性眩晕组的中风风险高于阑尾炎-输尿管结石组（风险比 1.73，95%置信区间 1.18-2.55），但低于缺血性中风组（风险比 0.30，95%置信区间 0.24-0.37）。外周性眩晕组的中风风险略低于小血管中风。外周性眩晕组的中风风险随时间显著变化：7 天内较高，7 天至 1 年之间中度，此后降低。高龄（>65 岁）、男性和糖尿病是外周性眩晕组中风的危险因素。
在急诊科被诊断为外周性眩晕的患者表现出中度的未来中风风险，因此需要根据症状发作的时间和个体风险制定针对性的中风预防策略。
