Risk of injury after emergency department visit for acute peripheral vertigo: a matched-cohort study.
Risk of injury after emergency department visit for acute peripheral vertigo: a matched-cohort study.
复制标题
DOI：
10.15441/ceem.19.064
复制
发表时间：
2020-09
影响因子：
1.9
通讯作者：
Kim J
中科院分区：
文献类型：
--
作者：
Kim H;Lee S;Kim J
周围性眩晕是急诊科（艾德）就诊的最常见原因之一。它会损害平衡，并可能使患者在出院后容易受伤。本研究的目的是确定周围性眩晕是否与创伤风险增加有关。这项匹配队列研究使用了2002年至2013年从真实的韩国人口中随机抽样的100万个人的去识别索赔信息的全国代表性数据集。暴露队列包括因新发周围性眩晕而就诊ED的患者，既往或同时无损伤。通过发病率密度抽样，将每位患者随机匹配至5名未暴露个体（也无既往损伤）。主要结局是1年内发生新损伤。次要结局是各种损伤亚型。使用扩展的考克斯模型对暴露的时间依赖性效应进行建模。年龄、性别、合并症和家庭收入水平作为协变量。共有776人和3，880人分别被纳入暴露和比较队列。暴露队列中躯干损伤和上肢损伤的风险显著较高。多变量校正的扩展考克斯模型显示，1年内风险显著增加，前1个月、1个月至3个月和3个月至1年的风险比为5.23（95%置信区间[CI]，2.83-9.64）; 1.50（95% CI，1.02-2.20）;和1.37（95% CI，1.11-1.68）。因急性周围性眩晕而到急诊室就诊的患者在长达一年的时间内发生新损伤的风险更高。
Peripheral vertigo is one of the most common causes of the emergency department (ED) visits. It can impair balance and might predispose patients to injuries after discharge. The purpose of this study was to determine whether peripheral vertigo is associated with an increased risk of trauma. This matched-cohort study used the nationally representative dataset of de-identified claim information of 1 million randomly sampled individuals from a real Korean population, from 2002 to 2013. The exposure cohort included patients who visited EDs for new-onset peripheral vertigo without prior or concurrent injury. Each patient was randomly matched to five unexposed individuals (also without previous injury) by incidence density sampling. The primary outcome was a new injury within 1 year. The secondary outcomes were various injury subtypes. The time-dependent effect of the exposure was modeled using the extended Cox model. Age, sex, comorbidities, and household income level were included as covariates. A total of 776 and 3,880 individuals were included as the exposure and comparison cohorts, respectively. The risks of trunk injury and upper extremity injury were significantly higher in the exposure cohort. Extended Cox models with multivariable adjustment showed significantly increased risk for up to 1 year, with the first 1-month; 1 month to 3 months; and 3 months to 1 year hazard ratios of 5.23 (95% confidence interval [CI], 2.83–9.64); 1.50 (95% CI, 1.02–2.20); and 1.37 (95% CI, 1.11–1.68), respectively. Patients visiting EDs for acute peripheral vertigo are at a higher risk of a new injury for up to a year.