Emergency Presentations for Dizziness—Radiological Findings, Final Diagnoses, and Mortality
Background. Dizziness is a frequent presentation in patients presenting to emergency departments (EDs), often triggering extensive work-up, including neuroimaging. Therefore, gathering knowledge on final diagnoses and outcomes is important. We aimed to describe the incidence of dizziness as primary...
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| Format: | Article |
| Language: | English |
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Wiley
2023-01-01
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| Series: | International Journal of Clinical Practice |
| Online Access: | http://dx.doi.org/10.1155/2023/7450009 |
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| author | Jeannette-Marie Busch Isabelle Arnold Julia Karakoumis David J. Winkel Martin Segeroth Christian H. Nickel Roland Bingisser |
| author_facet | Jeannette-Marie Busch Isabelle Arnold Julia Karakoumis David J. Winkel Martin Segeroth Christian H. Nickel Roland Bingisser |
| author_sort | Jeannette-Marie Busch |
| collection | DOAJ |
| description | Background. Dizziness is a frequent presentation in patients presenting to emergency departments (EDs), often triggering extensive work-up, including neuroimaging. Therefore, gathering knowledge on final diagnoses and outcomes is important. We aimed to describe the incidence of dizziness as primary or secondary complaint, to list final diagnoses, and to determine the use and yield of neuroimaging and outcomes in these patients. Methods. Secondary analysis of two observational cohort studies, including all patients presenting to the ED of the University Hospital of Basel from 30th January 2017–19th February 2017 and from 18th March 2019–20th May 2019. Baseline demographics, Emergency Severity Index (ESI), hospitalization, admission to Intensive Care Units (ICUs), and mortality were extracted from the electronic health record database. At presentation, patients underwent a structured interview about their symptoms, defining their primary and secondary complaints. Neuroimaging results were obtained from the picture archiving and communication system (PACS). Patients were categorized into three non-overlapping groups: dizziness as primary complaint, dizziness as secondary complaint, and absence of dizziness. Results. Of 10076 presentations, 232 (2.3%) indicated dizziness as their primary and 984 (9.8%) as their secondary complaint. In dizziness as primary complaint, the three (out of 73 main conditions defined) main diagnoses were nonspecific dizziness (47, 20.3%), dysfunction of the peripheral vestibular system (37, 15.9%), as well as somatization, depression, and anxiety (20, 8.6%). 104 of 232 patients (44.8%) underwent neuroimaging, with relevant findings in 5 (4.8%). In dizziness as primary complaint 30-day mortality was 0%. Conclusion. Work-up for dizziness in emergency presentations has to consider a broad differential diagnosis, but due to the low yield, it should include neuroimaging only in few and selected cases, particularly with additional neurological abnormalities. Presentation with primary dizziness carries a generally favorable prognosis lacking short-term mortality. . |
| format | Article |
| id | doaj-art-b7d16056dcc04aacae2fd5cfd3228c0b |
| institution | OA Journals |
| issn | 1742-1241 |
| language | English |
| publishDate | 2023-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | International Journal of Clinical Practice |
| spelling | doaj-art-b7d16056dcc04aacae2fd5cfd3228c0b2025-08-20T02:19:18ZengWileyInternational Journal of Clinical Practice1742-12412023-01-01202310.1155/2023/7450009Emergency Presentations for Dizziness—Radiological Findings, Final Diagnoses, and MortalityJeannette-Marie Busch0Isabelle Arnold1Julia Karakoumis2David J. Winkel3Martin Segeroth4Christian H. Nickel5Roland Bingisser6Emergency DepartmentEmergency DepartmentEmergency DepartmentDepartment of RadiologyDepartment of RadiologyEmergency DepartmentEmergency DepartmentBackground. Dizziness is a frequent presentation in patients presenting to emergency departments (EDs), often triggering extensive work-up, including neuroimaging. Therefore, gathering knowledge on final diagnoses and outcomes is important. We aimed to describe the incidence of dizziness as primary or secondary complaint, to list final diagnoses, and to determine the use and yield of neuroimaging and outcomes in these patients. Methods. Secondary analysis of two observational cohort studies, including all patients presenting to the ED of the University Hospital of Basel from 30th January 2017–19th February 2017 and from 18th March 2019–20th May 2019. Baseline demographics, Emergency Severity Index (ESI), hospitalization, admission to Intensive Care Units (ICUs), and mortality were extracted from the electronic health record database. At presentation, patients underwent a structured interview about their symptoms, defining their primary and secondary complaints. Neuroimaging results were obtained from the picture archiving and communication system (PACS). Patients were categorized into three non-overlapping groups: dizziness as primary complaint, dizziness as secondary complaint, and absence of dizziness. Results. Of 10076 presentations, 232 (2.3%) indicated dizziness as their primary and 984 (9.8%) as their secondary complaint. In dizziness as primary complaint, the three (out of 73 main conditions defined) main diagnoses were nonspecific dizziness (47, 20.3%), dysfunction of the peripheral vestibular system (37, 15.9%), as well as somatization, depression, and anxiety (20, 8.6%). 104 of 232 patients (44.8%) underwent neuroimaging, with relevant findings in 5 (4.8%). In dizziness as primary complaint 30-day mortality was 0%. Conclusion. Work-up for dizziness in emergency presentations has to consider a broad differential diagnosis, but due to the low yield, it should include neuroimaging only in few and selected cases, particularly with additional neurological abnormalities. Presentation with primary dizziness carries a generally favorable prognosis lacking short-term mortality. .http://dx.doi.org/10.1155/2023/7450009 |
| spellingShingle | Jeannette-Marie Busch Isabelle Arnold Julia Karakoumis David J. Winkel Martin Segeroth Christian H. Nickel Roland Bingisser Emergency Presentations for Dizziness—Radiological Findings, Final Diagnoses, and Mortality International Journal of Clinical Practice |
| title | Emergency Presentations for Dizziness—Radiological Findings, Final Diagnoses, and Mortality |
| title_full | Emergency Presentations for Dizziness—Radiological Findings, Final Diagnoses, and Mortality |
| title_fullStr | Emergency Presentations for Dizziness—Radiological Findings, Final Diagnoses, and Mortality |
| title_full_unstemmed | Emergency Presentations for Dizziness—Radiological Findings, Final Diagnoses, and Mortality |
| title_short | Emergency Presentations for Dizziness—Radiological Findings, Final Diagnoses, and Mortality |
| title_sort | emergency presentations for dizziness radiological findings final diagnoses and mortality |
| url | http://dx.doi.org/10.1155/2023/7450009 |
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