Yoo Dae Myoung, Yang Bo-Ram, Han Kyeongmin, Choi Hyo Geun, Choe Goun, Choi Jin Woong, Kim Bong Jik
Hallym Data Science Laboratory, College of Medicine, Hallym University, Anyang 14068, Republic of Korea.
College of Pharmacy, Chungnam National University, Daejeon 34134, Republic of Korea.
Diagnostics (Basel). 2025 Aug 27;15(17):2171. doi: 10.3390/diagnostics15172171.
: Benign paroxysmal positional vertigo (BPPV) is one of the most common vestibular disorders and is characterized by transient but very severe vertigo, increasing fall risk, especially in older people. While many risk factors have been reported, there are still contradicting papers and evidence from large-scale studies remains limited. : This nationwide, nested case-control study utilized Korean National Health Insurance Service-Health Screening Cohort data to investigate possible risk factors for BPPV. In particular, it examined the association between prior head trauma and BPPV, proposing prior head trauma as a plausible and clinically relevant risk factor. From an initial cohort of 514,866 participants, 29,467 BPPV cases were matched 1:4 with 117,868 controls based on age, sex, income, region, and index date. Conditional logistic regression, with overlap weighting, assessed the risk of BPPV associated with head trauma and other potential factors. : Head trauma was modestly more prevalent in the BPPV group (2.29% vs. 1.83%) and was significantly associated with BPPV (adjusted OR 1.28, 95% CI 1.17-1.40, < 0.001). The corresponding Absolute Risk Increase (ARI) was 0.82 percentage points over the entire follow-up and 0.66 percentage points within 1 year. The association persisted across most subgroups including both demographic and clinical factors except underweight individuals and those with high comorbidity scores. : This large-scale analysis reinforces head trauma as a significant risk factor for BPPV, providing population-level evidence that may guide clinical assessment and prevention strategies.
良性阵发性位置性眩晕（BPPV）是最常见的前庭疾病之一，其特征是短暂但非常严重的眩晕，增加了跌倒风险，尤其是在老年人中。虽然已经报道了许多风险因素，但仍有相互矛盾的文献，大规模研究的证据仍然有限。
这项全国性的巢式病例对照研究利用韩国国民健康保险服务-健康筛查队列数据来调查BPPV的可能风险因素。特别是，它研究了既往头部外伤与BPPV之间的关联，提出既往头部外伤是一个合理且与临床相关的风险因素。从最初的514,866名参与者队列中，根据年龄、性别、收入、地区和索引日期，将29,467例BPPV病例与117,868名对照按1:4进行匹配。采用重叠加权的条件逻辑回归评估与头部外伤和其他潜在因素相关的BPPV风险。
头部外伤在BPPV组中略为更常见（2.29%对1.83%），并且与BPPV显著相关（调整后的OR为1.28，95%CI为1.17-1.40，P<0.001）。相应的绝对风险增加（ARI）在整个随访期间为0.82个百分点，在1年内为0.66个百分点。除体重过轻个体和合并症评分高的个体外，该关联在包括人口统计学和临床因素在内的大多数亚组中均持续存在。
这项大规模分析强化了头部外伤是BPPV的一个重要风险因素，提供了可能指导临床评估和预防策略的人群水平证据。
