Araştırma Makalesi
BibTex RIS Kaynak Göster

An evaluation of patients who present to the emergency department with dizziness

Yıl 2022, Cilt: 2 Sayı: 4, 205 - 212, 17.10.2022

Öz

This study aimed to analyze the data of patients presenting with dizziness at our hospital’s emergency department (ED) by determining the etiology of dizziness and to contribute to the medical data of our country and the literature. This prospective study was conducted with 116 volunteering patients who presented to the Emergency Department of Afyon Kocatepe University, Faculty of Medicine for one year with dizziness complaints. After the anamnesis, physical examination, diagnostic tests (blood tests, Dix-Hallpike maneuver, audiological-vestibular tests, carotid-vertebral artery color Doppler ultrasonography, and computerized brain tomography), and psychiatric interrogation, the patients were divided into four etiology groups: Peripheral, central, psychogenic, and other causes of dizziness. Clinical features were compared between peripheral and central dizziness groups. A total of 116 (3.4%) of patient admissions to the emergency department complained of dizziness. Forty-nine (42.2%) of these patients were male, 67 (57.8%) were female. In the cohort, 33.9% were under 40, and dizziness increased with older age. Seventy (60.3%) patients had no formal education or were primary school graduates. The initial evaluation at the ED revealed that dizziness mostly shifted with the position (71.6%) and was mainly accompanied by headache (67.2%). Based on their diagnosis, 50 patients (43.1%) were in the peripheral group, 30 patients (25.8%) were in the central group, 22 patients (19%) were in the psychogenic dizziness group, and 14 patients (12%) were in the other causes group. Intergroup analysis between peripheral and central vertigo groups identified that the hearing loss, ear fullness, recent upper respiratory tract infection (URTI), nausea, vomiting, and shifting position was statistically significant (p<0.05). Dizziness is one of the common complaints of admission to the ED and may arise from different etiologies. Our study demonstrated that psychogenic dizziness was common in this patient cohort

Kaynakça

  • 1. Skiendzielewski JJ, Martyak G. The weak and dizzy patient. Ann Emerg Med. 1980;9(7):353-6. doi: 10.1016/s0196-0644(80)80111-9.
  • 2. Chu YT, Cheng L. Vertigo and dizziness. Acta Neurol Taiwan. 2007;16(1):50-60.
  • 3. Ljunggren M, Persson J, Salzer J. Dizziness and the acute vestibular syndrome at the emergency department: A population-based descriptive study. Eur Neurol. 2018;79(1-2):5-12. doi: 10.1159/000481982.
  • 4. Navi BB, Kamel H, Shah MP, Grossman AW, Wong C, Poisson SN, et al. Rate and predictors of serious neurologic causes of dizziness in the emergency department. Mayo Clin Proc. 2012;87(11):1080-8. doi: 10.1016/j.mayocp.2012.05.023.
  • 5. Furman JM, Jacob RG. Psychiatric dizziness. Neurology. 1997;48(5):1161-6. doi: 10.1212/wnl.48.5.1161.
  • 6. Shah H, Mukherjee S. Psychogenic Vertigo. Int J Otorhinolaryngol Clin. 2012;4(2):77-80. doi: 10.5005/jp-journals-10003-1090.
  • 7. Moulin T, Sablot D, Vidry E, Belahsen F, Berger E, Lemounaud P, et al. Impact of emergency room neurologists on patient management and outcome. Eur Neurol. 2003;50(4):207-14. doi: 10.1159/000073861.
  • 8. Newman-Toker DE, Hsieh YH, Camargo CA Jr, Pelletier AJ, Butchy GT, Edlow JA. Spectrum of dizziness visits to US emergency departments: Cross-sectional analysis from a nationally representative sample. Mayo Clin Proc. 2008;83(7):765-75. doi: 10.4065/83.7.765.
  • 9. Gulalp B, Karagun O, Aldinc H, Altinors MN. Dizziness in the emergency department. Eurasian J Emerg Med. 2009;8:20-3. doi: 10.4170/JAEM.2009.39974.
  • 10. Rybak LP. Metabolic disorders of the vestibular system. Otolaryngol Head Neck Surg. 1995;112(1):128-32. doi: 10.1016/S0194-59989570312-8
  • 11. Neuhauser HK, von Brevern M, Radtke A, Lezius F, Feldmann M, Ziese T, et al. Epidemiology of vestibular vertigo: A neurotologic survey of the general population. Neurology. 2005;65(6):898-904. doi: 10.1212/01.wnl.0000175987.59991.3d. Erratum in: Neurology. 2006;67(8):1528.
  • 12. Vuković V, Plavec D, Galinović I, Lovrencić-Huzjan A, Budisić M, Demarin V. Prevalence of vertigo, dizziness, and migrainous vertigo in patients with migraine. Headache. 2007(10):1427-35. doi: 10.1111/j.1526-4610.2007.00939. x.
  • 13. Neuhauser HK, Lempert T. Vertigo: Epidemioloaspects. Semin Neurol. 2009(5):473-81. doi: 10.1055/s-0029-1241043.
  • 14. Warninghoff JC, Bayer O, Ferrari U, Straube A. Co-morbidities of vertiginous diseases. BMC Neurol. 2009;9:29. doi: 10.1186/1471-2377-9-29.
  • 15. Kao AC, Nanda A, Williams CS, Tinetti ME. Validation of dizziness as a possible geriatric syndrome. J Am Geriatr Soc. 2001;49(1):72-5. doi: 10.1046/j.1532-5415.2001.49012.x.
  • 16. Chang J, Hwang SY, Park SK, Kim JH, Kim HJ, Chae SW, et al. Prevalence of dizziness and associated factors in South Korea: A cross-sectional survey from 2010 to 2012. J Epidemiol. 2018;28(4):176-84. doi: 10.2188/jea.JE20160113.
  • 17. Colledge NR, Wilson JA, Macintyre CC, MacLennan WJ. The prevalence and characteristics of dizziness in an elderly community. Age Ageing. 1994;23(2):117-20. doi: 10.1093/ageing/23.2.117.
  • 18. Kroenke K, Hoffman RM, Einstadter D. How common are various causes of dizziness? A critical review. South Med J. 2000;93(2):160-7.
  • 19. Koçer M, Avcı A, Gülen M, Avci BŞ, Satar S, Koç F. Analysis of the patients who applied to emergency medicine with dizziness. Cukurova Med J. 2019;44:579-86.
  • 20. Kroenke K, Lucas CA, Rosenberg ML, Scherokman B, Herbers JE Jr, Wehrle PA, et al. Causes of persistent dizziness. A prospective study of 100 patients in ambulatory care. Ann Intern Med. 1992;117(11):898-904. doi: 10.7326/0003-4819-117-11-898.
  • 21. Staab JP. Assessment and management of psychological problems in the dizzy patient. Continuum: Lifelong learning in neurology. LWW. 2006;12:189-213.
  • 22. Gomez F, Curcio CL, Duque G. Dizziness as a geriatric condition among rural community-dwelling older adults. J Nutr Health Aging. 2011;15(6):490-7. doi: 10.1007/s12603-011-0050-4.
  • 23. Idil H, Ozbay Yenice G, Kilic TY, Eyler Y, Duman Atilla O. The incidence of central neurological disorders among patients with isolated dizziness and the diagnostic yield of neuroimaging studies. Neurologist. 2020;25(4):85-8. doi: 10.1097/NRL.0000000000000282.
  • 24. Shahrami A, Norouzi M, Kariman H, Hatamabadi HR, Arhami Dolatabadi A. True vertigo patients in emergency department; an epidemiologic study. Emerg (Tehran). 2016;4(1):25-8.
  • 25. Baloh RW. Differentiating between peripheral and central causes of vertigo. Otolaryngol Head Neck Surg. 1998;119(1):55-9. doi: 10.1016/S0194-5998(98)70173-1.
  • 26. Labuguen RH. Initial evaluation of vertigo. Am Fam Physician. 2006;73(2):244-51. Erratum in: Am Fam Physician. 2006;73(10):1704.
Yıl 2022, Cilt: 2 Sayı: 4, 205 - 212, 17.10.2022

Öz

Kaynakça

  • 1. Skiendzielewski JJ, Martyak G. The weak and dizzy patient. Ann Emerg Med. 1980;9(7):353-6. doi: 10.1016/s0196-0644(80)80111-9.
  • 2. Chu YT, Cheng L. Vertigo and dizziness. Acta Neurol Taiwan. 2007;16(1):50-60.
  • 3. Ljunggren M, Persson J, Salzer J. Dizziness and the acute vestibular syndrome at the emergency department: A population-based descriptive study. Eur Neurol. 2018;79(1-2):5-12. doi: 10.1159/000481982.
  • 4. Navi BB, Kamel H, Shah MP, Grossman AW, Wong C, Poisson SN, et al. Rate and predictors of serious neurologic causes of dizziness in the emergency department. Mayo Clin Proc. 2012;87(11):1080-8. doi: 10.1016/j.mayocp.2012.05.023.
  • 5. Furman JM, Jacob RG. Psychiatric dizziness. Neurology. 1997;48(5):1161-6. doi: 10.1212/wnl.48.5.1161.
  • 6. Shah H, Mukherjee S. Psychogenic Vertigo. Int J Otorhinolaryngol Clin. 2012;4(2):77-80. doi: 10.5005/jp-journals-10003-1090.
  • 7. Moulin T, Sablot D, Vidry E, Belahsen F, Berger E, Lemounaud P, et al. Impact of emergency room neurologists on patient management and outcome. Eur Neurol. 2003;50(4):207-14. doi: 10.1159/000073861.
  • 8. Newman-Toker DE, Hsieh YH, Camargo CA Jr, Pelletier AJ, Butchy GT, Edlow JA. Spectrum of dizziness visits to US emergency departments: Cross-sectional analysis from a nationally representative sample. Mayo Clin Proc. 2008;83(7):765-75. doi: 10.4065/83.7.765.
  • 9. Gulalp B, Karagun O, Aldinc H, Altinors MN. Dizziness in the emergency department. Eurasian J Emerg Med. 2009;8:20-3. doi: 10.4170/JAEM.2009.39974.
  • 10. Rybak LP. Metabolic disorders of the vestibular system. Otolaryngol Head Neck Surg. 1995;112(1):128-32. doi: 10.1016/S0194-59989570312-8
  • 11. Neuhauser HK, von Brevern M, Radtke A, Lezius F, Feldmann M, Ziese T, et al. Epidemiology of vestibular vertigo: A neurotologic survey of the general population. Neurology. 2005;65(6):898-904. doi: 10.1212/01.wnl.0000175987.59991.3d. Erratum in: Neurology. 2006;67(8):1528.
  • 12. Vuković V, Plavec D, Galinović I, Lovrencić-Huzjan A, Budisić M, Demarin V. Prevalence of vertigo, dizziness, and migrainous vertigo in patients with migraine. Headache. 2007(10):1427-35. doi: 10.1111/j.1526-4610.2007.00939. x.
  • 13. Neuhauser HK, Lempert T. Vertigo: Epidemioloaspects. Semin Neurol. 2009(5):473-81. doi: 10.1055/s-0029-1241043.
  • 14. Warninghoff JC, Bayer O, Ferrari U, Straube A. Co-morbidities of vertiginous diseases. BMC Neurol. 2009;9:29. doi: 10.1186/1471-2377-9-29.
  • 15. Kao AC, Nanda A, Williams CS, Tinetti ME. Validation of dizziness as a possible geriatric syndrome. J Am Geriatr Soc. 2001;49(1):72-5. doi: 10.1046/j.1532-5415.2001.49012.x.
  • 16. Chang J, Hwang SY, Park SK, Kim JH, Kim HJ, Chae SW, et al. Prevalence of dizziness and associated factors in South Korea: A cross-sectional survey from 2010 to 2012. J Epidemiol. 2018;28(4):176-84. doi: 10.2188/jea.JE20160113.
  • 17. Colledge NR, Wilson JA, Macintyre CC, MacLennan WJ. The prevalence and characteristics of dizziness in an elderly community. Age Ageing. 1994;23(2):117-20. doi: 10.1093/ageing/23.2.117.
  • 18. Kroenke K, Hoffman RM, Einstadter D. How common are various causes of dizziness? A critical review. South Med J. 2000;93(2):160-7.
  • 19. Koçer M, Avcı A, Gülen M, Avci BŞ, Satar S, Koç F. Analysis of the patients who applied to emergency medicine with dizziness. Cukurova Med J. 2019;44:579-86.
  • 20. Kroenke K, Lucas CA, Rosenberg ML, Scherokman B, Herbers JE Jr, Wehrle PA, et al. Causes of persistent dizziness. A prospective study of 100 patients in ambulatory care. Ann Intern Med. 1992;117(11):898-904. doi: 10.7326/0003-4819-117-11-898.
  • 21. Staab JP. Assessment and management of psychological problems in the dizzy patient. Continuum: Lifelong learning in neurology. LWW. 2006;12:189-213.
  • 22. Gomez F, Curcio CL, Duque G. Dizziness as a geriatric condition among rural community-dwelling older adults. J Nutr Health Aging. 2011;15(6):490-7. doi: 10.1007/s12603-011-0050-4.
  • 23. Idil H, Ozbay Yenice G, Kilic TY, Eyler Y, Duman Atilla O. The incidence of central neurological disorders among patients with isolated dizziness and the diagnostic yield of neuroimaging studies. Neurologist. 2020;25(4):85-8. doi: 10.1097/NRL.0000000000000282.
  • 24. Shahrami A, Norouzi M, Kariman H, Hatamabadi HR, Arhami Dolatabadi A. True vertigo patients in emergency department; an epidemiologic study. Emerg (Tehran). 2016;4(1):25-8.
  • 25. Baloh RW. Differentiating between peripheral and central causes of vertigo. Otolaryngol Head Neck Surg. 1998;119(1):55-9. doi: 10.1016/S0194-5998(98)70173-1.
  • 26. Labuguen RH. Initial evaluation of vertigo. Am Fam Physician. 2006;73(2):244-51. Erratum in: Am Fam Physician. 2006;73(10):1704.
Toplam 26 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Sağlık Kurumları Yönetimi
Bölüm Original Articles
Yazarlar

Oya Akpınar Oruç Bu kişi benim 0000-0003-2515-0956

Neşe Nur User Bu kişi benim

Yayımlanma Tarihi 17 Ekim 2022
Yayımlandığı Sayı Yıl 2022 Cilt: 2 Sayı: 4

Kaynak Göster

Vancouver Akpınar Oruç O, User NN. An evaluation of patients who present to the emergency department with dizziness. Health Sci. Q. 2022;2(4):205-12.