Stroke among patients with dizziness, vertigo, and imbalance in the emergency department - A population-based study
Stroke among patients with dizziness, vertigo, and imbalance in the emergency department - A population-based study
复制标题
DOI：
10.1161/01.str.0000240329.48263.0d
复制
发表时间：
2006-10-01
期刊：
影响因子：
8.3
通讯作者：
Morgenstern, Lewis B.
中科院分区：
文献类型：
--
作者：
Kerber, Kevin A.;Brown, Devin L.;Morgenstern, Lewis B.
背景和目的：头晕、眩晕和失衡是急诊科常见的症状。中风是一个主要的问题，即使这些症状单独发生。本研究的目的是确定患有头晕症状（DS）到急诊室就诊的患者中中风的“现实”比例。方法-根据一项基于人群的研究，年龄> 44岁的患有DS的患者到急诊室就诊，或直接入院，被确定。评估了人口统计学、新发脑血管事件的频率和孤立性DS（即无其他卒中筛选术语或伴随神经系统体征或症状的DS）的频率。采用多变量logistic回归分析评价年龄、性别、种族和孤立性DS与卒中/短暂性脑缺血发作（TIA）的相关性。与中风/短暂性脑缺血发作的表现症状的关联也assessed.Results-Stroke/短暂性脑缺血发作被诊断为3.2%（53 1666）的所有患者与DS。仅0.7%（9/1297）的孤立性DS患者发生卒中/TIA。发生卒中/TIA的患者年龄略大于未发生卒中/TIA的患者（69.3 +/- 11.7 vs 65.3 +/- 12.9，P=0.02）。男性与卒中/TIA相关，而孤立性DS与卒中/TIA呈负相关。不平衡的患者（头晕作为参考）更有可能有中风/TIA. Conclusions脑血管事件的比例在头晕，眩晕，或不平衡的患者是非常低的。单独的头晕、眩晕或失衡强烈预示非脑血管原因。失衡症状是卒中/TIA的预测因子。
Background and Purpose-Dizziness, vertigo, and imbalance are common presenting symptoms in the emergency department. Stroke is a leading concern even when these symptoms occur in isolation. The objective of the present study was to determine the "real-world" proportion of stroke among patients presenting to the emergency department with these dizziness symptoms (DS).Methods-From a population-based study, patients > 44 years of age presenting with DS to the emergency department, or directly admitted to the hospital, were identified. Demographics, the frequency of new cerebrovascular events, and the frequency of isolated DS (ie DS with no other stroke screening term or accompanying neurologic signs or symptoms) were assessed. Multivariable logistic regression was used to evaluate the association of age, gender, ethnicity, and isolated DS with stroke/transient ischemic attack (TIA). The association of the presenting symptoms with stroke/TIA was also assessed.Results-Stroke/TIA was diagnosed in 3.2% (53 of 1666) of all patients with DS. Only 0.7% (9 of 1297) of those with isolated DS had a stroke/TIA. Patients with stroke/TIA were slightly older than those without stroke/TIA (69.3 +/- 11.7 vs 65.3 +/- 12.9, P=0.02). Male gender was associated with stroke/TIA, whereas isolated DS was negatively associated with stroke/TIA. Patients with imbalance (dizziness as referent) were more likely to have stroke/TIA.Conclusions-The proportion of cerebrovascular events in patients presenting with dizziness, vertigo, or imbalance is very low. Isolated dizziness, vertigo, or imbalance strongly predicts a noncerebrovascular cause. The symptom of imbalance is a predictor of stroke/TIA.