BACKGROUND AND PURPOSE: vertigo is a common presenting symptom in ambulatory care settings, and stroke is its leading and most challenging concern. This study aimed to determine the risk of stroke in vertigo patients in a 4-year follow-up after hospitalization for acute isolated vertigo. METHODS: the study cohorts consisted of all patients hospitalized with a principal diagnosis of vertigo (n=3021), whereas patients hospitalized for an appendectomy in 2004 (n=3021) comprised the control group and surrogate for the general population. Cox proportional hazard model was performed as a means of comparing the 4-year stroke-free survival rate between the 2 cohorts after adjusting for possible confounding and risk factors. Among vertigo patients, there was further stratification for risk factors to identify the group at high risk for stroke. RESULTS: of the 243 stroke patients, 185 (6.1%) were from the study cohort and 58 (1.9%) were from the control group. Comparing the 2 groups, patients with vertigo symptoms had a 3.01-times (95% CI, 2.20-4.11; P<0.001) higher risk for stroke after adjusting for patient characteristics, comorbidities, geographic region, urbanization level of residence, and socioeconomic status. Vertigo patients with ≥ 3 risk factors had a 5.51-fold higher risk for stroke (95% CI, 3.10-9.79; P<0.001) than those without risk factors. CONCLUSIONS: vertigo patients are at higher risk for stroke than the general population. They should have a comprehensive neurological examination, vascular risk factors survey, and regular follow-up for several years after hospital discharge after treatment of isolated vertigo.
BACKGROUND AND PURPOSE:vertigo is a common presenting symptom in ambulatory care settings, and stroke is its leading and most challenging concern. This study aimed to determine the risk of stroke in vertigopatients in a 4-year follow-up after hospitalization for acute isolated vertigo. METHODS: the study cohorts consisted of all patients hospitalized with a principal diagnosis of vertigo (n=3021), whereas patients hospitalized for an appendectomy in 2004 (n=3021) comprised the control group and surrogate for the general population. Cox proportional hazard model was performed as a means of comparing the 4-year stroke-free survival rate between the 2 cohorts after adjusting for possible confounding and risk factors. Among vertigopatients, there was further stratification for risk factors to identify the group at high risk for stroke. RESULTS: of the 243 strokepatients, 185 (6.1%) were from the study cohort and 58 (1.9%) were from the control group. Comparing the 2 groups, patients with vertigo symptoms had a 3.01-times (95% CI, 2.20-4.11; P<0.001) higher risk for stroke after adjusting for patient characteristics, comorbidities, geographic region, urbanization level of residence, and socioeconomic status. Vertigopatients with ≥ 3 risk factors had a 5.51-fold higher risk for stroke (95% CI, 3.10-9.79; P<0.001) than those without risk factors. CONCLUSIONS:vertigopatients are at higher risk for stroke than the general population. They should have a comprehensive neurological examination, vascular risk factors survey, and regular follow-up for several years after hospital discharge after treatment of isolated vertigo.
Authors: Kevin A Kerber; Darin B Zahuranec; Devin L Brown; William J Meurer; James F Burke; Melinda A Smith; Lynda D Lisabeth; A Mark Fendrick; Thomas McLaughlin; Lewis B Morgenstern Journal: Ann Neurol Date: 2014-05-26 Impact factor: 10.422
Authors: Tzu-Pu Chang; Zheyu Wang; Ariel A Winnick; Hsun-Yang Chuang; Victor C Urrutia; John P Carey; David E Newman-Toker Journal: J Stroke Cerebrovasc Dis Date: 2017-11-01 Impact factor: 2.136