Risk of Stroke in Patients Hospitalized for Isolated Vertigo


Lee Ching-Chih1,Su Yu-Chieh1,Ho Hsu-Chieh1,Hung Shih-Kai1,Lee Moon-Sing1,Chou Pesus1,Huang Yung-Sung1


1. From the Community Medicine Research Center and Institute of Public Health (C.C.L., P.C.), National Yang-Ming University, Taipei, Taiwan; Department of Otolaryngology (C.C.L., H.C.H.), Division of Hematology-Oncology (Y.C.S., S.K.H.), Department of Internal Medicine, Department of Radiation Oncology (M.S.L.), Tumor Center (C.C.L., Y.C.S., H.C.H., S.K.H., M.S.L.), Division of Neurology (Y.S.H.), Department of Internal Medicine, Buddhist Dalin Tzu Chi General Hospital, Chiayi, Taiwan; School of...


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.


Ovid Technologies (Wolters Kluwer Health)


Advanced and Specialized Nursing,Cardiology and Cardiovascular Medicine,Neurology (clinical)

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