Yıl: 2023 Cilt: 30 Sayı: 2 Sayfa Aralığı: 220 - 225 Metin Dili: İngilizce DOI: 10.5455/annalsmedres.2022.10.320 İndeks Tarihi: 04-04-2023

Importance of vertigo classification in the emergency department and its effects on economic burden

Öz:
Aim: Patients with vertigo present to the emergency department with their clinical status and social comfort significantly impaired. More importantly, diseases that can pose a life-threatening risk may also underlying vertigo. In our study, we aimed to detect life- threatening conditions in vertigo patients early, and to alleviate the economic burden by preventing unnecessary radiological imaging in emergency services. Materials and Methods: Three hundred eighteen patients were included in the study. The patients were divided into two groups as peripheral and central vertigo. Patients’ age, sex, temperature, pulse, and arterial blood pressure values were examined. The complaints at admission were grouped as dizziness, dizziness+nausea-vomiting, and dizzi- ness+neurological complaint. Furthermore, patients’ examination findings, history of diseases, and laboratory data were recorded. Radiological imaging methods used in the emergency department, the requested consultations, peripheral-central vertigo, and hospitalization-discharge status were examined. Results: Of all patients, 287 (90.3%) and 31 (9.7%) had peripheral and central vertigo, respectively. The mean age of patients with peripheral vertigo was 52.34±17.38 years, while the mean age of patients with central vertigo was 68.06±19.56 years. There was a statistically significant difference between peripheral-central vertigo and age. A statis- tically significant difference was revealed between peripheral-central vertigo and systolic and diastolic blood pressure. In laboratory data, we found a significant difference between peripheral-central vertigo and glucose and CRP. Hypertension was the most common dis- ease in the history. Conclusion: The etiology of vertigo should be clarified quickly and reliably in emergency departments. To this end, the patient’s complaints and the findings obtained as a result of the examination along with auxiliary radiological imaging methods are vital. Thus, the diagnosis and treatment of patients with severe vertigo will be performed earlier, and unnecessary radiological imaging will be prevented. As a result, the economic burden will also decrease with the decrease in the examinations performed.
Anahtar Kelime: Economic burden Emergency department Clinical features Radiological imaging Vertigo

Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık
  • 1. Dilci A, Cevizci R. Evaluation of Main Inflammatory Markers on Peripheral Vertigo Attack. New Trend Med Sci 2021; 2(1): 45-49.
  • 2. von Brevern M, Radtke A, Lezius F, et al. Epidemiology of be- nign parosymal positional vertigo: a population based study. J Neurol Neurosurg Psychiatry. 2007;78(7):710-5.
  • 3. de Joode LEGH, Martin EC, Stultiens JJA. The DizzyQuest: to have or not to have. . . a vertigo attack? J Neurol. 2020;267(Suppl 1):15-23.
  • 4. Goldman B. Vertigo and Dizziness. In Tintinalli’s Emergency Medicine: A Comprehensive Study Guide, 7th ed ( Eds JE Jalli, JS Stapczynski, DM Cline), New York, McGraw-Hill, 2011;1144- 52.
  • 5. Quimby AE, Kwok ESH, Lelli D, et al. Usage of the HINTS exam and neuroimaging in the assessment of peripheral vertigo in the emergency department. J Otolaryngol Head Neck Surg. 2018;47(1):54.
  • 6. Sarıca S, İnanç Y, İnanç Y. An assessment of vertigo patients presenting to the otorhinolaryngology and neurology outpatient clinics. Eur Res J. 2019;5(4):594-8.
  • 7. Savitz SI, Caplan LR, Edlow JA. Pitfalls in the diagnosis of cerebellar infarction. Acad Emerg Med. 2007;14:63-8.
  • 8. Tarnutzer AA, Berkowit AL, Robinson KA, et al. Does my dizzy patient have a stroke? A systematic review of bedside diagnosis in acute vestibular syndrome. CMAJ. 2011;183(9):E571 –92.
  • 9. Newman-Toker DE, Hsieh YH, Camargo CA Jr, et al. Spec- trum of dizziness visits to US emergency departments: cross- sectional analysis from a nationally representative sample. Mayo Clin Proc. 2008;83(7):765–75.
  • 10. Kerber KA. Vertigo and dizziness in the emergency department. Emerg Med Clin North Am. 2009;27(1):9–50, viii.
  • 11. Pfieffer ML, Anthamatten A, Glassford M. Assessment and treatment of dizziness and vertigo. Nurse Pract. 2019;44(10):29- 36.
  • 12. Little N. Vertigo and dizziness. Tintinalli, J.E, Ruiz, E., Krome, R.L. Emergency medicine a comprehensive study guıde fourth edition. 2004; 1021-6.
  • 13. Kroenke K, Lucas CA, Rosenberg ML, et al. Causes of persistent dizziness. A prospective study of 100 patient in ambulatory care. Ann. Intern. Med. 1992;117(11):898-904.
  • 14. Abdul-Baqi KJ, MohammedFI, Shubair KS, et al. Evaluation of dizziness at Jordan University Hospital. Saudi Med. J. 2004;25: 625-31.
  • 15. Hain TC, Yacovino D. Pharmacologic treatment of persons with dizziness. Neurol Clin. 2005;23:831-5.
  • 16. Narita S, Kurose M, Kobayashi K, Himi T. Study on 242 inpa- tients reporting vertigo and dizziness. Nippon Jibiinkoka Gakkai Kaiho. 2003;106(1):21-7.
  • 17. Uno A, Nagai M, SakataY, et al. Statistical observation of ver- tigo and dizziness patients. Nippon Jibiinkoka Gakkai Kaiho. 2001;104(12):1119-25.
  • 18. Karatas M. Central vertigo and dizziness: epidemiol- ogy, differential diagnosis, and common causes. Neurologist. 2008;14(6):355-64.
  • 19. 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;122(2):145-9.
  • 20. Huang CQ, Dong BR, Lu ZC, et al. Chronic diseases and risk for depression in old age: A meta-analysis of published literature. Ageing Research Reviews. 2010;9(2):131-41.
  • 21. O’Brien C, Gross D. http://www.vestibularseminars.com/ his- toryalgorithm.html. Updated Vestibular Algorithm. 2014.
  • 22. Nakatsuka M, Molloy EE. The HINTS examination and STAND- ING algorithm in acute vestibular syndrome: A systematic re- view and meta-analysis involving frontline point-of-care emer- gency physicians. PLoS ONE. 2022;17(5):e0266252.
  • 23. Vanni S, Pecci R, Edlow JA, et al. Differential Diagnosis of Ver- tigo in the Emergency Department: A Prospective Validation Study of the STANDING Algorithm. Front Neurol. 2017;8:590.
  • 24. Sloane PD. Dizziness in primary care. Results from the National Ambulatory Medical Care Survey. J Fam Pract. 1989;29(1):33-8.
  • 25. Ruthberg JS, Rasendran C, Kocharyan A, et al. The economic burden of vertigo and dizziness in the United States. J Vestib Res.. 2021;31(2):81-90.
  • 26. Saber Tehrani AS, Coughlan D, Hsieh YH, et al. Rising annual costs of dizziness presentations to U.S. emergency departments. Acad Emerg Med. 2013;20(7):689-96.
  • 27. Aktaş A, Durak VA, Akköse Aydın Ş. Acil servise vertigo şikayeti ile başvuran hastaların prospektif incelenmesi. Uludağ Üniver- sitesi Tıp Fakültesi Dergisi. 2019;45(1):71-75.
  • 28. Flossmann E, Redgrave JN, Briley D, Rothwell PM. Relia- bility of clinical diagnosis of thesymptomatic vascular terri- tory in patients with recent transient ischemic attack or minor stroke.Stroke. Sep; 2008 39(9):2457–60.
  • 29. Edlow JA, Newman-Toker DE, Savitz SI. Diagnosis and ini- tial management of cerebellar infarction.Lancet Neurol. 2008 7(10):951–64.
  • 30. Yıldırım N, Topuz MF, Aksoy C. Kütahya Sağlık Bilimleri Üniversitesi Tıp Fakültesi Evliya Çelebi Eğitim ve Araştırma Hastanesine 2018 yılında Başvuran Baş Dönmeli Hastaların Epi- demiyolojik Analizi. KBB-Forum. 2020;19(3):296-303.
  • 31. Kerber KA, Meurer WJ, West BT, Fendrick AM. Dizziness presentations in US emergency departments, 1995-2004. Acad Emerg Med. 2008;15(8):744-50.
  • 32. Burt CW, Schappert SM. Ambulatory care visits to physician offices, hospital outpatient departments, and emergency de- partments: United States, 1999--2000. Vital Health Stat 13. 2004;(157):1-70.
  • 33. Kroenke K, Mangelsdorff AD. Common symptoms in ambula- tory care: incidence, evaluation, therapy, and outcome. Am J Med. 1989;86(3):262-6.
  • 34. Kovacs E, Wang X, Grill E. Economic burden of vertigo: a sys- tematic review. Health Econ Rev. 2019;9(1):37.
APA Ekmekyapar M, Ekmekyapar T, GÜRBÜZ S (2023). Importance of vertigo classification in the emergency department and its effects on economic burden. , 220 - 225. 10.5455/annalsmedres.2022.10.320
Chicago Ekmekyapar Muhammed,Ekmekyapar Tuba,GÜRBÜZ SÜKRÜ Importance of vertigo classification in the emergency department and its effects on economic burden. (2023): 220 - 225. 10.5455/annalsmedres.2022.10.320
MLA Ekmekyapar Muhammed,Ekmekyapar Tuba,GÜRBÜZ SÜKRÜ Importance of vertigo classification in the emergency department and its effects on economic burden. , 2023, ss.220 - 225. 10.5455/annalsmedres.2022.10.320
AMA Ekmekyapar M,Ekmekyapar T,GÜRBÜZ S Importance of vertigo classification in the emergency department and its effects on economic burden. . 2023; 220 - 225. 10.5455/annalsmedres.2022.10.320
Vancouver Ekmekyapar M,Ekmekyapar T,GÜRBÜZ S Importance of vertigo classification in the emergency department and its effects on economic burden. . 2023; 220 - 225. 10.5455/annalsmedres.2022.10.320
IEEE Ekmekyapar M,Ekmekyapar T,GÜRBÜZ S "Importance of vertigo classification in the emergency department and its effects on economic burden." , ss.220 - 225, 2023. 10.5455/annalsmedres.2022.10.320
ISNAD Ekmekyapar, Muhammed vd. "Importance of vertigo classification in the emergency department and its effects on economic burden". (2023), 220-225. https://doi.org/10.5455/annalsmedres.2022.10.320
APA Ekmekyapar M, Ekmekyapar T, GÜRBÜZ S (2023). Importance of vertigo classification in the emergency department and its effects on economic burden. Annals of Medical Research, 30(2), 220 - 225. 10.5455/annalsmedres.2022.10.320
Chicago Ekmekyapar Muhammed,Ekmekyapar Tuba,GÜRBÜZ SÜKRÜ Importance of vertigo classification in the emergency department and its effects on economic burden. Annals of Medical Research 30, no.2 (2023): 220 - 225. 10.5455/annalsmedres.2022.10.320
MLA Ekmekyapar Muhammed,Ekmekyapar Tuba,GÜRBÜZ SÜKRÜ Importance of vertigo classification in the emergency department and its effects on economic burden. Annals of Medical Research, vol.30, no.2, 2023, ss.220 - 225. 10.5455/annalsmedres.2022.10.320
AMA Ekmekyapar M,Ekmekyapar T,GÜRBÜZ S Importance of vertigo classification in the emergency department and its effects on economic burden. Annals of Medical Research. 2023; 30(2): 220 - 225. 10.5455/annalsmedres.2022.10.320
Vancouver Ekmekyapar M,Ekmekyapar T,GÜRBÜZ S Importance of vertigo classification in the emergency department and its effects on economic burden. Annals of Medical Research. 2023; 30(2): 220 - 225. 10.5455/annalsmedres.2022.10.320
IEEE Ekmekyapar M,Ekmekyapar T,GÜRBÜZ S "Importance of vertigo classification in the emergency department and its effects on economic burden." Annals of Medical Research, 30, ss.220 - 225, 2023. 10.5455/annalsmedres.2022.10.320
ISNAD Ekmekyapar, Muhammed vd. "Importance of vertigo classification in the emergency department and its effects on economic burden". Annals of Medical Research 30/2 (2023), 220-225. https://doi.org/10.5455/annalsmedres.2022.10.320