| A Simple Prediction Method of Central Vertigo Among Patients with Dizziness in the Emergency Department |
| Soo Hyun Kim, Chun Song Youn, Seung Pill Choi, Kyu Nam Park |
| Department of Emergency Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea. ycs1005@catholic.ac.kr |
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| ABSTRACT |
PURPOSE:
The symptoms of dizziness are common in the emergency department, accounting for 1~2% of all emergency department visits. Central vertigo, especially stroke is a leading concern when these symptoms occur in isolated condition. However, no method is available to discriminate isolated central vertigo from peripheral vertigo. The objectives of the present study were to evaluate the clinical usefulness of the simple prediction method of central vertigo among patients presenting with the symptoms of dizziness in the emergency department.
METHODS:
A three-year retrospective study with symptoms of dizziness was performed in a university teaching hospital between 1st January 2005 and 31st December 2007.
Multivariate logistic regression analysis of all clinical parameters was performed for a model comprising 10 variables to form a St. Mary's dizziness prediction score.
RESULTS:
A total of 1058 patients were enrolled. Among central vertigo patients, 70 were ischemic stroke, 8 vertebrobasilar insufficiency, 3 hemorrhagic stroke and 1 had a brain tumor. The odds ratio of the predictor variables were (1) 2.13 for men, (2) 7.18 for disequilibrium, (3) 3.49 for headache, (4) 7.17 for falling tendency, (5) 2.96 for risk factor score 1, and (6) 8.71 for risk factor score 2.
Each of these variables was assigned a score 1 or 2 to obtain a total of 8. The risk of central vertigo was 2.64%, 25.60%, and 84.21% for the low, intermediate, and high risk groups, respectively.
CONCLUSION:
St. Mary's dizziness prediction score is a simple and relatively reliable tool for accessing the symptoms of dizziness and diagnosing isolated central vertigo in the emergency department. |
| Key words:
Dizziness, Vertigo, Differential diagnosis |
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