Department of Otolaryngology-Head and Neck Surgery, University of Nebraska Medical Center.
College of Medicine, University of Nebraska Medical Center.
Otol Neurotol. 2023 Mar 1;44(3):e178-e183. doi: 10.1097/MAO.0000000000003792. Epub 2023 Jan 8.
To examine the risk factors for hip fracture in patients with vestibular disorders and the association between antihistamine use and hip fracture in patients with vestibular disorders.
Retrospective case series with chart review.
Tertiary academic medical center.
A retrospective review of adult patients with hip fracture based on International Classification of Diseases, Tenth Revision (ICD-10) code S72 from January 2013 to December 2019 who had previously been diagnosed with a vestibular disorder based on ICD-10 codes H81-83, A88.1, and R42.
A total of 201 patients were identified meeting the inclusion criteria. The average age at the time of hip fracture was 78.8 years and the majority were female (64.7%). Most patients were diagnosed with nonspecific dizziness (60.2%) or vertigo (23.9%). Those with a peripheral vestibular disorder included benign paroxysmal positional vertigo (BPPV) in 13.4% and Ménière's disease in 2.5%. Overall, meclizine was prescribed to 38.3% of patients, including 29.9% of patients before hip fracture. Meclizine was prescribed to 66.7% of patients with BPPV. Patients were seen for vestibular symptoms 0.67 ± 2.51 years before hip fracture, and 98 patients (48.8%) presented with vestibular concerns within 1 year prior.
Patients with vestibular disorders who sustain a ground level fall resulting in hip fracture are a vulnerable population of predominantly older adults with multiple comorbidities. Patients were frequently diagnosed with dizziness or vertigo rather than more specific causes being identified. Multifactorial interventions to prevent hip fractures in older adults have been recommended; however, this study suggests that meclizine use was common among patients diagnosed with dizziness, vertigo, or BPPV before hip fracture.
探讨前庭障碍患者髋部骨折的危险因素，以及前庭障碍患者使用抗组胺药物与髋部骨折之间的关系。
回顾性病例系列，病历回顾。
三级学术医疗中心。
根据国际疾病分类第 10 版（ICD-10）代码 S72，回顾 2013 年 1 月至 2019 年 12 月期间因髋部骨折住院的成年患者，这些患者之前被诊断为前庭障碍，诊断依据为 ICD-10 代码 H81-83、A88.1 和 R42。
共纳入 201 例符合纳入标准的患者。髋部骨折时的平均年龄为 78.8 岁，大多数为女性（64.7%）。大多数患者被诊断为非特异性头晕（60.2%）或眩晕（23.9%）。前庭功能障碍患者中包括良性阵发性位置性眩晕（BPPV）占 13.4%，梅尼埃病占 2.5%。总体而言，有 38.3%的患者被开具了倍他司汀，其中髋部骨折前有 29.9%的患者被开具了倍他司汀。BPPV 患者中有 66.7%的患者被开具了倍他司汀。患者因前庭症状就诊的时间为髋部骨折前 0.67±2.51 年，98 例（48.8%）患者在髋部骨折前 1 年内出现了前庭问题。
因地面跌倒导致髋部骨折的前庭障碍患者是一个脆弱的人群，主要为有多种合并症的老年人。患者经常被诊断为头晕或眩晕，而不是更具体的病因。已推荐对老年人进行预防髋部骨折的多因素干预；然而，这项研究表明，在髋部骨折之前，倍他司汀被广泛用于诊断为头晕、眩晕或 BPPV 的患者。
