Inpatient Treatment of Patients Admitted for Dizziness: A Population-Based Healthcare Research Study on Epidemiology, Diagnosis, Treatment, and Outcome
OBJECTIVE:To determine inpatient treatment rates of patients with dizziness with focus on diagnostics, treatment and outcome. STUDY DESIGN:Retrospective population-based study. SETTING:Inpatients in the federal state Thuringia in 2014. PATIENTS:All 1,262 inpatients (62% females, median age61 yr) tre...
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Veröffentlicht in: | Otology & neurotology 2017-12, Vol.38 (10), p.e460-e469 |
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creator | Renner, Vera Geißler, Katharina Boeger, Daniel Buentzel, Jens Esser, Dirk Hoffmann, Kerstin Jecker, Peter Mueller, Andreas Radtke, Gerald Axer, Hubertus Guntinas-Lichius, Orlando |
description | OBJECTIVE:To determine inpatient treatment rates of patients with dizziness with focus on diagnostics, treatment and outcome.
STUDY DESIGN:Retrospective population-based study.
SETTING:Inpatients in the federal state Thuringia in 2014.
PATIENTS:All 1,262 inpatients (62% females, median age61 yr) treated for inpatient dizziness were included.
MAIN OUTCOME MEASURES:The association between analyzed parameters and probability of improvement and recovery was tested using univariable and multivariable statistics.
RESULTS:Final diagnosis at demission was peripheral vestibular disorder (PVD), central vestibular disorder (CVD), cardiovascular syndrome, somatoform syndrome, and unclassified disease in 75, 9, 3, 0.6, and 13%, respectively. The most frequent diseases were acute vestibular neuritis (28%) and benign paroxysmal positional vertigo (22%). The follow-up time was 38 ± 98 days. 88.5% of patients showed at least an improvement of complaints and 31.4% a complete recovery. The probability for no improvement from inpatient dizziness was higher if the patient had a history of ear/vestibular disease (hazard ratio [HR] = 1.506; 95% confidence interval [CI] = 1.301–1.742), and was taking more than two drugs for comorbidity (HR = 1.163; CI = 1.032–1.310). Compared with final diagnosis of cardiovascular syndrome, patients with PVD (HR = 1.715; CI = 1.219–2.415) and CVD (HR = 1.587; CI = 1.076–2.341) had a worse outcome.
CONCLUSIONS:Inpatient treatment of dizziness was highly variable in daily practice. The population-based recovery rate was worse than reported in clinical trials. We need better ways to implement clinical trial findings for inpatients with dizziness. |
doi_str_mv | 10.1097/MAO.0000000000001568 |
format | Article |
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STUDY DESIGN:Retrospective population-based study.
SETTING:Inpatients in the federal state Thuringia in 2014.
PATIENTS:All 1,262 inpatients (62% females, median age61 yr) treated for inpatient dizziness were included.
MAIN OUTCOME MEASURES:The association between analyzed parameters and probability of improvement and recovery was tested using univariable and multivariable statistics.
RESULTS:Final diagnosis at demission was peripheral vestibular disorder (PVD), central vestibular disorder (CVD), cardiovascular syndrome, somatoform syndrome, and unclassified disease in 75, 9, 3, 0.6, and 13%, respectively. The most frequent diseases were acute vestibular neuritis (28%) and benign paroxysmal positional vertigo (22%). The follow-up time was 38 ± 98 days. 88.5% of patients showed at least an improvement of complaints and 31.4% a complete recovery. The probability for no improvement from inpatient dizziness was higher if the patient had a history of ear/vestibular disease (hazard ratio [HR] = 1.506; 95% confidence interval [CI] = 1.301–1.742), and was taking more than two drugs for comorbidity (HR = 1.163; CI = 1.032–1.310). Compared with final diagnosis of cardiovascular syndrome, patients with PVD (HR = 1.715; CI = 1.219–2.415) and CVD (HR = 1.587; CI = 1.076–2.341) had a worse outcome.
CONCLUSIONS:Inpatient treatment of dizziness was highly variable in daily practice. The population-based recovery rate was worse than reported in clinical trials. We need better ways to implement clinical trial findings for inpatients with dizziness.</description><identifier>ISSN: 1531-7129</identifier><identifier>EISSN: 1537-4505</identifier><identifier>DOI: 10.1097/MAO.0000000000001568</identifier><identifier>PMID: 28938275</identifier><language>eng</language><publisher>United States: Copyright by Otology & Neurotology, Inc. Image copyright Wolters Kluwer Health/Anatomical Chart Company</publisher><subject>Adolescent ; Adult ; Aged ; Aged, 80 and over ; Benign Paroxysmal Positional Vertigo - epidemiology ; Cardiovascular Diseases - complications ; Cardiovascular Diseases - epidemiology ; Child ; Child, Preschool ; Dizziness - diagnosis ; Dizziness - epidemiology ; Dizziness - therapy ; Female ; Germany - epidemiology ; Guideline Adherence ; Humans ; Inpatients ; Male ; Middle Aged ; Population ; Retrospective Studies ; Treatment Outcome ; Vestibular Diseases - diagnosis ; Vestibular Diseases - epidemiology ; Vestibular Diseases - therapy ; Vestibular Neuronitis - diagnosis ; Vestibular Neuronitis - epidemiology ; Vestibular Neuronitis - therapy ; Young Adult</subject><ispartof>Otology & neurotology, 2017-12, Vol.38 (10), p.e460-e469</ispartof><rights>Copyright © 2017 by Otology & Neurotology, Inc. Image copyright © 2010 Wolters Kluwer Health/Anatomical Chart Company</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3568-5ddaf22b2098d95ca854c568283a24957e92b2b9a2cda6c947ea7a520e5b94fc3</citedby><cites>FETCH-LOGICAL-c3568-5ddaf22b2098d95ca854c568283a24957e92b2b9a2cda6c947ea7a520e5b94fc3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27901,27902</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/28938275$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Renner, Vera</creatorcontrib><creatorcontrib>Geißler, Katharina</creatorcontrib><creatorcontrib>Boeger, Daniel</creatorcontrib><creatorcontrib>Buentzel, Jens</creatorcontrib><creatorcontrib>Esser, Dirk</creatorcontrib><creatorcontrib>Hoffmann, Kerstin</creatorcontrib><creatorcontrib>Jecker, Peter</creatorcontrib><creatorcontrib>Mueller, Andreas</creatorcontrib><creatorcontrib>Radtke, Gerald</creatorcontrib><creatorcontrib>Axer, Hubertus</creatorcontrib><creatorcontrib>Guntinas-Lichius, Orlando</creatorcontrib><title>Inpatient Treatment of Patients Admitted for Dizziness: A Population-Based Healthcare Research Study on Epidemiology, Diagnosis, Treatment, and Outcome</title><title>Otology & neurotology</title><addtitle>Otol Neurotol</addtitle><description>OBJECTIVE:To determine inpatient treatment rates of patients with dizziness with focus on diagnostics, treatment and outcome.
STUDY DESIGN:Retrospective population-based study.
SETTING:Inpatients in the federal state Thuringia in 2014.
PATIENTS:All 1,262 inpatients (62% females, median age61 yr) treated for inpatient dizziness were included.
MAIN OUTCOME MEASURES:The association between analyzed parameters and probability of improvement and recovery was tested using univariable and multivariable statistics.
RESULTS:Final diagnosis at demission was peripheral vestibular disorder (PVD), central vestibular disorder (CVD), cardiovascular syndrome, somatoform syndrome, and unclassified disease in 75, 9, 3, 0.6, and 13%, respectively. The most frequent diseases were acute vestibular neuritis (28%) and benign paroxysmal positional vertigo (22%). The follow-up time was 38 ± 98 days. 88.5% of patients showed at least an improvement of complaints and 31.4% a complete recovery. The probability for no improvement from inpatient dizziness was higher if the patient had a history of ear/vestibular disease (hazard ratio [HR] = 1.506; 95% confidence interval [CI] = 1.301–1.742), and was taking more than two drugs for comorbidity (HR = 1.163; CI = 1.032–1.310). Compared with final diagnosis of cardiovascular syndrome, patients with PVD (HR = 1.715; CI = 1.219–2.415) and CVD (HR = 1.587; CI = 1.076–2.341) had a worse outcome.
CONCLUSIONS:Inpatient treatment of dizziness was highly variable in daily practice. The population-based recovery rate was worse than reported in clinical trials. We need better ways to implement clinical trial findings for inpatients with dizziness.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Benign Paroxysmal Positional Vertigo - epidemiology</subject><subject>Cardiovascular Diseases - complications</subject><subject>Cardiovascular Diseases - epidemiology</subject><subject>Child</subject><subject>Child, Preschool</subject><subject>Dizziness - diagnosis</subject><subject>Dizziness - epidemiology</subject><subject>Dizziness - therapy</subject><subject>Female</subject><subject>Germany - epidemiology</subject><subject>Guideline Adherence</subject><subject>Humans</subject><subject>Inpatients</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Population</subject><subject>Retrospective Studies</subject><subject>Treatment Outcome</subject><subject>Vestibular Diseases - diagnosis</subject><subject>Vestibular Diseases - epidemiology</subject><subject>Vestibular Diseases - therapy</subject><subject>Vestibular Neuronitis - diagnosis</subject><subject>Vestibular Neuronitis - epidemiology</subject><subject>Vestibular Neuronitis - therapy</subject><subject>Young Adult</subject><issn>1531-7129</issn><issn>1537-4505</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kcFO3DAQhq2KqtCFN6iQjxw2NHHidcxtS5eyEtUiSs_RrD1hDUkcbEdo90X6uhgW2ooDc5nRzDf_yP4J-ZKlx1kqxdef08Vx-l9kfFJ-IHsZz0VS8JTvPNdZIjImd8ln728jI3IuPpFdVsq8ZILvkT_zrodgsAv02iGE9qmyNb3cNj2d6taEgJrW1tHvZrMxHXp_Qqf00vZDEzHbJd_AR-IcoQkrBQ7pFXoEp1b0Vxj0mtqOznqjsTW2sTfrcRSCm85648f_zo4pdJouhqBsi_vkYw2Nx4OXPCK_z2bXp-fJxeLH_HR6kag8vjfhWkPN2JKlstSSKyh5oeKAlTmwQnKBMg6XEpjSMFGyEAgCOEuRL2VRq3xEjra6vbP3A_pQtcYrbBro0A6-ymTBRComBYtosUWVs947rKvemRbcusrS6smSKlpSvbUkrh2-XBiWLeq_S68eRKDcAg-2Cej8XTM8oKtWz7_5vvYjineZ7Q</recordid><startdate>201712</startdate><enddate>201712</enddate><creator>Renner, Vera</creator><creator>Geißler, Katharina</creator><creator>Boeger, Daniel</creator><creator>Buentzel, Jens</creator><creator>Esser, Dirk</creator><creator>Hoffmann, Kerstin</creator><creator>Jecker, Peter</creator><creator>Mueller, Andreas</creator><creator>Radtke, Gerald</creator><creator>Axer, Hubertus</creator><creator>Guntinas-Lichius, Orlando</creator><general>Copyright by Otology & Neurotology, Inc. Image copyright Wolters Kluwer Health/Anatomical Chart Company</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>201712</creationdate><title>Inpatient Treatment of Patients Admitted for Dizziness: A Population-Based Healthcare Research Study on Epidemiology, Diagnosis, Treatment, and Outcome</title><author>Renner, Vera ; Geißler, Katharina ; Boeger, Daniel ; Buentzel, Jens ; Esser, Dirk ; Hoffmann, Kerstin ; Jecker, Peter ; Mueller, Andreas ; Radtke, Gerald ; Axer, Hubertus ; Guntinas-Lichius, Orlando</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3568-5ddaf22b2098d95ca854c568283a24957e92b2b9a2cda6c947ea7a520e5b94fc3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Benign Paroxysmal Positional Vertigo - epidemiology</topic><topic>Cardiovascular Diseases - complications</topic><topic>Cardiovascular Diseases - epidemiology</topic><topic>Child</topic><topic>Child, Preschool</topic><topic>Dizziness - diagnosis</topic><topic>Dizziness - epidemiology</topic><topic>Dizziness - therapy</topic><topic>Female</topic><topic>Germany - epidemiology</topic><topic>Guideline Adherence</topic><topic>Humans</topic><topic>Inpatients</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Population</topic><topic>Retrospective Studies</topic><topic>Treatment Outcome</topic><topic>Vestibular Diseases - diagnosis</topic><topic>Vestibular Diseases - epidemiology</topic><topic>Vestibular Diseases - therapy</topic><topic>Vestibular Neuronitis - diagnosis</topic><topic>Vestibular Neuronitis - epidemiology</topic><topic>Vestibular Neuronitis - therapy</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Renner, Vera</creatorcontrib><creatorcontrib>Geißler, Katharina</creatorcontrib><creatorcontrib>Boeger, Daniel</creatorcontrib><creatorcontrib>Buentzel, Jens</creatorcontrib><creatorcontrib>Esser, Dirk</creatorcontrib><creatorcontrib>Hoffmann, Kerstin</creatorcontrib><creatorcontrib>Jecker, Peter</creatorcontrib><creatorcontrib>Mueller, Andreas</creatorcontrib><creatorcontrib>Radtke, Gerald</creatorcontrib><creatorcontrib>Axer, Hubertus</creatorcontrib><creatorcontrib>Guntinas-Lichius, Orlando</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Otology & neurotology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Renner, Vera</au><au>Geißler, Katharina</au><au>Boeger, Daniel</au><au>Buentzel, Jens</au><au>Esser, Dirk</au><au>Hoffmann, Kerstin</au><au>Jecker, Peter</au><au>Mueller, Andreas</au><au>Radtke, Gerald</au><au>Axer, Hubertus</au><au>Guntinas-Lichius, Orlando</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Inpatient Treatment of Patients Admitted for Dizziness: A Population-Based Healthcare Research Study on Epidemiology, Diagnosis, Treatment, and Outcome</atitle><jtitle>Otology & neurotology</jtitle><addtitle>Otol Neurotol</addtitle><date>2017-12</date><risdate>2017</risdate><volume>38</volume><issue>10</issue><spage>e460</spage><epage>e469</epage><pages>e460-e469</pages><issn>1531-7129</issn><eissn>1537-4505</eissn><abstract>OBJECTIVE:To determine inpatient treatment rates of patients with dizziness with focus on diagnostics, treatment and outcome.
STUDY DESIGN:Retrospective population-based study.
SETTING:Inpatients in the federal state Thuringia in 2014.
PATIENTS:All 1,262 inpatients (62% females, median age61 yr) treated for inpatient dizziness were included.
MAIN OUTCOME MEASURES:The association between analyzed parameters and probability of improvement and recovery was tested using univariable and multivariable statistics.
RESULTS:Final diagnosis at demission was peripheral vestibular disorder (PVD), central vestibular disorder (CVD), cardiovascular syndrome, somatoform syndrome, and unclassified disease in 75, 9, 3, 0.6, and 13%, respectively. The most frequent diseases were acute vestibular neuritis (28%) and benign paroxysmal positional vertigo (22%). The follow-up time was 38 ± 98 days. 88.5% of patients showed at least an improvement of complaints and 31.4% a complete recovery. The probability for no improvement from inpatient dizziness was higher if the patient had a history of ear/vestibular disease (hazard ratio [HR] = 1.506; 95% confidence interval [CI] = 1.301–1.742), and was taking more than two drugs for comorbidity (HR = 1.163; CI = 1.032–1.310). Compared with final diagnosis of cardiovascular syndrome, patients with PVD (HR = 1.715; CI = 1.219–2.415) and CVD (HR = 1.587; CI = 1.076–2.341) had a worse outcome.
CONCLUSIONS:Inpatient treatment of dizziness was highly variable in daily practice. The population-based recovery rate was worse than reported in clinical trials. We need better ways to implement clinical trial findings for inpatients with dizziness.</abstract><cop>United States</cop><pub>Copyright by Otology & Neurotology, Inc. Image copyright Wolters Kluwer Health/Anatomical Chart Company</pub><pmid>28938275</pmid><doi>10.1097/MAO.0000000000001568</doi></addata></record> |
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subjects | Adolescent Adult Aged Aged, 80 and over Benign Paroxysmal Positional Vertigo - epidemiology Cardiovascular Diseases - complications Cardiovascular Diseases - epidemiology Child Child, Preschool Dizziness - diagnosis Dizziness - epidemiology Dizziness - therapy Female Germany - epidemiology Guideline Adherence Humans Inpatients Male Middle Aged Population Retrospective Studies Treatment Outcome Vestibular Diseases - diagnosis Vestibular Diseases - epidemiology Vestibular Diseases - therapy Vestibular Neuronitis - diagnosis Vestibular Neuronitis - epidemiology Vestibular Neuronitis - therapy Young Adult |
title | Inpatient Treatment of Patients Admitted for Dizziness: A Population-Based Healthcare Research Study on Epidemiology, Diagnosis, Treatment, and Outcome |
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