Evaluation of patients with dizziness who applied to emergency service

Mürsel Koçer; Akkan Avcı; Müge Gülen; Begüm Şeyda Avci; Salim Satar; Filiz Koç

doi:10.17826/cumj.457648

Araştırma Makalesi

Evaluation of patients with dizziness who applied to emergency service

Yıl 2019, Cilt: 44 Sayı: 2, 579 - 586, 30.06.2019

Mürsel Koçer Akkan Avcı Müge Gülen Begüm Şeyda Avci Salim Satar Filiz Koç

https://doi.org/10.17826/cumj.457648

Cited By: 1

Öz

Purpose: The aim of this study was to evaluate the demographic characteristics of the patients presenting to the emergency room with dizziness, the etiologic causes leading to the complaints and the laboratory findings as well as the prognosis.

Materials and methods: The file data of a total of 5,056 patients admitted to the Adana Numune Training and Research Hospital Emergency Medicine Clinic between January 2013 and January 2015 were reviewed retrospectively. Mean, standard deviation, median, lowest, highest, frequency and ratio values were used in the descriptive statistics of the data.

Results: Two thousand nine hundred four of the patients were female (57.4%), 2,152 were male (42.6%) and the average age was 53.6 (± 18.2) years. It was determined that the complaints were common in the population between the ages of 51-70, and peripheric peripheral vertigo (n: 4.130, 81.6%), systemic causes (n: 664, 13.1%), and central vertigo (n: 249, 4.9%) were the most prevalent etiologies, respectively. It was determined that 83% of the patients were discharged following necessary procedures in the emergency room.

Conclusion: Dizziness is one of the most important symptoms that bring patients to the emergency services. While many etiologies play a part, it is determined that neurological and cardiological evaluations must be done. Patients can mainly be managed in emergency services by simple maneuvering or medical treatment options.

Anahtar Kelimeler

Emergency Medicine, Dizziness, Vertigo

Kaynakça

References1. Thompson TL, Amedee R. Vertigo: A Review of Common Peripheral and Central Vestibular Disorders. Ochsner J. 2009; 9(1): 20–26.
2. Cappello M, di Blasi U, di Piazza L, Ducato G, Ferrara A, Franco S, et al. Dizziness and vertigo in a department of emergency medicine. Eur J Emerg Med 1995 Dec;2(4):201-11.
3. Yardley L, Linda L. Treating dizziness with vestibular rehabilitation. British Medical Journal 308.6939 (1994): 1252.
4. Sloane PD. Dizziness in primary care. J Fam Pract 1989;29(1):33–38.
5. Kerber KA, Meurer WJ, West BT, Fendrick AM. Dizziness presentations in U.S. emergency departments, 1995–2004. Acad Emerg Med. 2008;15(8):744–750.
6. Post RE, Dickerson LM. Dizziness: A diagnostic approach. Am Fam Physician 2010 Aug 15;82(4):361-8.
7. Kroenke K, Lucas CA, Rosenberg ML, Scherokman B, Herbers JE Jr, Wehrle PA, et al. Causes of persistent dizziness: a prospective study of 100 patients in ambulatory care. Ann Intern Med 117.11 (1992): 898-904.
8. Herr RD, Leslie Z, James JM. A directed approach to the dizzy patient. Ann Emerg Med 18.6 (1989): 664-672.
9. Narita S, Kurose M, Kobayashi K Himi T. Study on 242 inpatients reporting vertigo and dizziness. Nippon Jibiinkoka Gakkai Kaiho. 2003 Jan;106(1):21-7.
10. Arya AK, Nunez DA. What proportion of patients referred to an otolaryngology vertigo clinic have an otological cause for their symptoms? J Laryngol Otol 2008 Feb;122(2):145-9.
11. Navi BB, Kamel H, Shah MP, Grossman AW, Wong C, Poisson SN, et al. Rate and predictors of serious neurologic causes of dizziness in the emergency department. Mayo Clin Proc 2012 Nov;87(11):1080-8.
12. Uno A, Nagai M, Sakata Y, Moriwaki K, Kato T. Statistical observation of vertigo and dizziness patients. Nippon Jibiinkoka Gakkai Kaiho 2001; 104: 1119–25.
13. Katsarkas A. Dizziness in aging: a retrospective study of 1194 cases. Otolaryngol Head Neck Surg 1994 Mar;110(3):296-301.
14. Maarsingh OR, Stam H, van de Ven PM, van Schoor NM, Ridd MJ, van der Wouden JC. Predictors of dizziness in older persons: a 10-year prospective cohort study in the community. BMC geriatr 14.1 (2014): 1.
15. Shahrami A, Norouzi M, Kariman H, Hatamabadi HR, Arhami Dolatabadi A. True vertigo patients in emergency department; an epidemiologic study. Emergency 2016;4(1):25-28.
16. Warninghoff JC, Bayer O, Ferrari U, Straube A. Co-morbidities of vertiginous diseases. BMC Neurol 2009 Jul 7;9:29.
17. Agrawal, Yuri, Carey JP, Della Santina CC, Schubert MC, Minor LB. Diabetes, vestibular dysfunction, and falls: analyses from the National Health and Nutrition Examination Survey. Otol Neurotol 2010 Dec;31(9):1445-50.
18. Cianfrone, G, Pentangelo D, Cianfrone F, Mazzei F, Turchetta R, Orlando MP, et al. Pharmacological drugs inducing ototoxicity, vestibular symptoms and tinnitus: a reasoned and updated guide. Eur Rev Med Pharmacol Sci 15.6 (2011): 601-636.
19. Cianfrone G, Pace M, Turchetta R, Cianfrone F, Altissimi G. An updated guide on drugs inducing ototoxicity, tinnitus and vertigo. Acta Otorhinolaryngol Ital 2005 Oct;25(5 Suppl 81):3-31.
20. Chimirri S, Aiello R, Mazzitello C, Mumoli L, Palleria C, Altomonte M, et al. Vertigo/dizziness as a Drugs’ adverse reaction. J Pharmacol Pharmacother 2013 Dec;4(Suppl 1):S104-9.
21. Zhou Y, Sun PH, Liu YW, Zhao X, Meng L, Cui YM. Safety and Pharmacokinetic Studies of Silodosin, a New. ALPHA. 1A-Adrenoceptor Selective Antagonist, in Healthy Chinese Male Subjects. Biol Pharm Bull 2011;34(8):1240-5.
22. Horn J. The proton-pump inhibitors: similarities and differences. Clin Ther 2000 Mar;22(3):266-80
23. Fitzgerald KT, Bronstein AC. Selective serotonin reuptake inhibitor exposure. Top Companion Anim Med 2013;28:13-7.
24. Lode H. Borner K, Koeppe P. Pharmacodynamics of fluoroquinolones. Clin Infect Dis 27.1 (1998): 33-39.
25. Hirose T, Uwahodo Y, Yamada S, Miwa T, Kikuchi T, Kitagawa H et al. Mechanism of action of aripiprazole predicts clinical efficacy and a favourable side-effect profile. J Psychopharmacol 2004 Sep;18(3):375-83.
26. Maag R, Sun S, Hannon M, Davies R, Alagona P, Foy A. Positive predictive value of an elevated cardiac troponin for type I myocardial infarction in ED patients based on the chief complaint. Am J Emerg Med 2015 Apr;33(4):516-20.
27. Alvord LS, Herr RD. ENG in the emergency room: subtest results in acutely dizzy patients. J Am Acad Audiol 1994 Nov;5(6):384-9.
28. Newman-Toker DE, Hsieh YH, Camargo CA Jr, Pelletier AJ, Butchy GT, Edlow JA. Spectrum of dizziness visits to US emergency departments: cross-sectional analysis from a nationally representative sample. Mayo Clin Proc 2008 Jul;83(7):765-75.
29. Kroenke K, Richard MH, Douglas E. How common are various causes of dizziness? A critical review. South Med J 2000 Feb;93(2):160-7.
30. Warach S, Gaa J, Siewert B, Wielopolski P, Edelman RR. Acute human stroke studied by whole brain echo planar diffusion-weighted magnetic resonance imaging. Ann Neurol 1995 Feb;37(2):231-41.
31. Fiebach JB, Schellinger PD, Jansen O, Meyer M, Wilde P, Bender J, et al. CT and diffusion-weighted MR imaging in randomized order Diffusion-weighted imaging results in higher accuracy and lower interrater variability in the diagnosis of hyperacute ischemic stroke. Stroke 2002 Sep;33(9):2206-10.
32. Chalela JA, Kidwell CS, Nentwich LM, Luby M, Butman JA, Demchuk AM, et al. Magnetic resonance imaging and computed tomography in emergency assessment of patients with suspected acute stroke: a prospective comparison. Lancet 2007 Jan 27;369(9558):293-8.
33. Oppenheim C, Stanescu R, Dormont D, Crozier S, Marro B, Samson Y, et al. False-negative diffusion-weighted MR findings in acute ischemic stroke. AJNR Am J Neuroradiol 2000 Sep;21(8):1434-40.

Acil servise başvuran baş dönmesi olan hastaların değerlendirilmesi

Yıl 2019, Cilt: 44 Sayı: 2, 579 - 586, 30.06.2019

Mürsel Koçer Akkan Avcı Müge Gülen Begüm Şeyda Avci Salim Satar Filiz Koç

https://doi.org/10.17826/cumj.457648

Cited By: 1

Öz

Amaç: Bu çalışmanın amacı, acil servise baş dönmesi olan hastaların demografik özelliklerini, şikayete neden olan etyolojik nedenleri, laboratuvar bulgularını ve prognozu değerlendirmektir.

Gereç ve yöntem: Adana Numune Eğitim ve Araştırma Hastanesi Acil Tıp Kliniğine Ocak 2013-Ocak 2015 tarihleri arasında başvuran toplam 5.056 hastanın dosya verileri retrospektif olarak incelendi. Verilerin tanımlayıcı istatistiklerinde ortalama, standart sapma, ortanca, en düşük, en yüksek, frekans ve oran değerleri kullanılmıştır.

Bulgular: İki bin dokuz yüz dört hasta (% 57.4) kadın, 2.152'si erkek (% 42.6) ve yaş ortalaması 53.6 (± 18.2) idi. Şikâyetlerin 51-70 yaş arası periferik periferik vertigo (n: 4.130,% 81.6), sistemik nedenler (n: 664,% 13.1) ve santral vertigo (n: 249) arasında yaygın olduğu saptanmıştır. En sık görülen etiyolojiler ise% 4.9'du. Acil serviste gerekli prosedürleri takiben hastaların% 83'ünün taburcu olduğu tespit edildi.

Sonuç: Baş dönmesi, hastaları acil servise getiren en önemli belirtilerden biridir. Pek çok etiyolojinin bir parçası olmasına rağmen, nörolojik ve kardiyolojik değerlendirmelerin yapılması gerektiği belirlenir. Hastalar genellikle basit manevra veya tıbbi tedavi seçenekleri ile acil servislerde yönetilebilir.

Anahtar Kelimeler

acil servis, vertigo, baş dönmesi

Kaynakça

References1. Thompson TL, Amedee R. Vertigo: A Review of Common Peripheral and Central Vestibular Disorders. Ochsner J. 2009; 9(1): 20–26.
2. Cappello M, di Blasi U, di Piazza L, Ducato G, Ferrara A, Franco S, et al. Dizziness and vertigo in a department of emergency medicine. Eur J Emerg Med 1995 Dec;2(4):201-11.
3. Yardley L, Linda L. Treating dizziness with vestibular rehabilitation. British Medical Journal 308.6939 (1994): 1252.
4. Sloane PD. Dizziness in primary care. J Fam Pract 1989;29(1):33–38.
5. Kerber KA, Meurer WJ, West BT, Fendrick AM. Dizziness presentations in U.S. emergency departments, 1995–2004. Acad Emerg Med. 2008;15(8):744–750.
6. Post RE, Dickerson LM. Dizziness: A diagnostic approach. Am Fam Physician 2010 Aug 15;82(4):361-8.
7. Kroenke K, Lucas CA, Rosenberg ML, Scherokman B, Herbers JE Jr, Wehrle PA, et al. Causes of persistent dizziness: a prospective study of 100 patients in ambulatory care. Ann Intern Med 117.11 (1992): 898-904.
8. Herr RD, Leslie Z, James JM. A directed approach to the dizzy patient. Ann Emerg Med 18.6 (1989): 664-672.
9. Narita S, Kurose M, Kobayashi K Himi T. Study on 242 inpatients reporting vertigo and dizziness. Nippon Jibiinkoka Gakkai Kaiho. 2003 Jan;106(1):21-7.
10. Arya AK, Nunez DA. What proportion of patients referred to an otolaryngology vertigo clinic have an otological cause for their symptoms? J Laryngol Otol 2008 Feb;122(2):145-9.
11. Navi BB, Kamel H, Shah MP, Grossman AW, Wong C, Poisson SN, et al. Rate and predictors of serious neurologic causes of dizziness in the emergency department. Mayo Clin Proc 2012 Nov;87(11):1080-8.
12. Uno A, Nagai M, Sakata Y, Moriwaki K, Kato T. Statistical observation of vertigo and dizziness patients. Nippon Jibiinkoka Gakkai Kaiho 2001; 104: 1119–25.
13. Katsarkas A. Dizziness in aging: a retrospective study of 1194 cases. Otolaryngol Head Neck Surg 1994 Mar;110(3):296-301.
14. Maarsingh OR, Stam H, van de Ven PM, van Schoor NM, Ridd MJ, van der Wouden JC. Predictors of dizziness in older persons: a 10-year prospective cohort study in the community. BMC geriatr 14.1 (2014): 1.
15. Shahrami A, Norouzi M, Kariman H, Hatamabadi HR, Arhami Dolatabadi A. True vertigo patients in emergency department; an epidemiologic study. Emergency 2016;4(1):25-28.
16. Warninghoff JC, Bayer O, Ferrari U, Straube A. Co-morbidities of vertiginous diseases. BMC Neurol 2009 Jul 7;9:29.
17. Agrawal, Yuri, Carey JP, Della Santina CC, Schubert MC, Minor LB. Diabetes, vestibular dysfunction, and falls: analyses from the National Health and Nutrition Examination Survey. Otol Neurotol 2010 Dec;31(9):1445-50.
18. Cianfrone, G, Pentangelo D, Cianfrone F, Mazzei F, Turchetta R, Orlando MP, et al. Pharmacological drugs inducing ototoxicity, vestibular symptoms and tinnitus: a reasoned and updated guide. Eur Rev Med Pharmacol Sci 15.6 (2011): 601-636.
19. Cianfrone G, Pace M, Turchetta R, Cianfrone F, Altissimi G. An updated guide on drugs inducing ototoxicity, tinnitus and vertigo. Acta Otorhinolaryngol Ital 2005 Oct;25(5 Suppl 81):3-31.
20. Chimirri S, Aiello R, Mazzitello C, Mumoli L, Palleria C, Altomonte M, et al. Vertigo/dizziness as a Drugs’ adverse reaction. J Pharmacol Pharmacother 2013 Dec;4(Suppl 1):S104-9.
21. Zhou Y, Sun PH, Liu YW, Zhao X, Meng L, Cui YM. Safety and Pharmacokinetic Studies of Silodosin, a New. ALPHA. 1A-Adrenoceptor Selective Antagonist, in Healthy Chinese Male Subjects. Biol Pharm Bull 2011;34(8):1240-5.
22. Horn J. The proton-pump inhibitors: similarities and differences. Clin Ther 2000 Mar;22(3):266-80
23. Fitzgerald KT, Bronstein AC. Selective serotonin reuptake inhibitor exposure. Top Companion Anim Med 2013;28:13-7.
24. Lode H. Borner K, Koeppe P. Pharmacodynamics of fluoroquinolones. Clin Infect Dis 27.1 (1998): 33-39.
25. Hirose T, Uwahodo Y, Yamada S, Miwa T, Kikuchi T, Kitagawa H et al. Mechanism of action of aripiprazole predicts clinical efficacy and a favourable side-effect profile. J Psychopharmacol 2004 Sep;18(3):375-83.
26. Maag R, Sun S, Hannon M, Davies R, Alagona P, Foy A. Positive predictive value of an elevated cardiac troponin for type I myocardial infarction in ED patients based on the chief complaint. Am J Emerg Med 2015 Apr;33(4):516-20.
27. Alvord LS, Herr RD. ENG in the emergency room: subtest results in acutely dizzy patients. J Am Acad Audiol 1994 Nov;5(6):384-9.
28. Newman-Toker DE, Hsieh YH, Camargo CA Jr, Pelletier AJ, Butchy GT, Edlow JA. Spectrum of dizziness visits to US emergency departments: cross-sectional analysis from a nationally representative sample. Mayo Clin Proc 2008 Jul;83(7):765-75.
29. Kroenke K, Richard MH, Douglas E. How common are various causes of dizziness? A critical review. South Med J 2000 Feb;93(2):160-7.
30. Warach S, Gaa J, Siewert B, Wielopolski P, Edelman RR. Acute human stroke studied by whole brain echo planar diffusion-weighted magnetic resonance imaging. Ann Neurol 1995 Feb;37(2):231-41.
31. Fiebach JB, Schellinger PD, Jansen O, Meyer M, Wilde P, Bender J, et al. CT and diffusion-weighted MR imaging in randomized order Diffusion-weighted imaging results in higher accuracy and lower interrater variability in the diagnosis of hyperacute ischemic stroke. Stroke 2002 Sep;33(9):2206-10.
32. Chalela JA, Kidwell CS, Nentwich LM, Luby M, Butman JA, Demchuk AM, et al. Magnetic resonance imaging and computed tomography in emergency assessment of patients with suspected acute stroke: a prospective comparison. Lancet 2007 Jan 27;369(9558):293-8.
33. Oppenheim C, Stanescu R, Dormont D, Crozier S, Marro B, Samson Y, et al. False-negative diffusion-weighted MR findings in acute ischemic stroke. AJNR Am J Neuroradiol 2000 Sep;21(8):1434-40.

Toplam 33 adet kaynakça vardır.

Ayrıntılar

Birincil Dil	İngilizce
Konular	Sağlık Kurumları Yönetimi
Bölüm	Araştırma
Yazarlar	Mürsel Koçer 0000-0002-1548-8630 Akkan Avcı 0000-0002-4627-0909 Müge Gülen 0000-0002-5080-3501 Begüm Şeyda Avci Bu kişi benim 0000-0001-6149-9341 Salim Satar 0000-0001-6080-4287 Filiz Koç Bu kişi benim 0000-0001-8594-7540
Yayımlanma Tarihi	30 Haziran 2019
Kabul Tarihi	21 Kasım 2018
Yayımlandığı Sayı	Yıl 2019 Cilt: 44 Sayı: 2

Kaynak Göster

MLA	Koçer, Mürsel vd. “Evaluation of Patients With Dizziness Who Applied to Emergency Service”. Cukurova Medical Journal, c. 44, sy. 2, 2019, ss. 579-86, doi:10.17826/cumj.457648.

Cited By

The etiological, demographic, and seasonal characteristics of patients with dizziness and vertigo

Journal of Surgery and Medicine

https://doi.org/10.28982/josam.7562

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