Health-related quality of life and disability in patients with acute unilateral peripheral vestibular disorders

Petri, Maria; Chirilă, Magdalena; Bolboacă, Sorana D.; Cosgarea, Marcel

doi:10.1016/j.bjorl.2016.08.004

Cited by 17 publications

(14 citation statements)

References 20 publications

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“…Women perceived greater disability as a result of BPPV than men. This finding is consistent with reports by Petri et al [26] for patients with peripheral unilateral vestibular diseases, including BPPV. We were surprised to see that patients with subjective posterior canal BPPV reported greater levels of perceived disability.…”

Section: Discussionsupporting

confidence: 94%

“…The median total score on the DHI-S, 16, was slightly lower than scores reported for specialist settings (mean, SD: 19.79 ± 10.,14) [19]; (17.19 ± 9.06) [37] although a similar score has also been reported (16,4 ± 10.71) [20]. It was also lower than the mean scores of 17.72 (SD = 9.98) and 22.67 (12.55) reported for patients with unilateral and bilateral Ménière disease, respectively [26, 38].…”

Section: Discussionmentioning

confidence: 60%

“…There were over three times more women than men in our series (female to male ratio, 3.19). Women are often more numerous than men in studies of BPPV [2, 26–28], perhaps because the disease is more prevalent in women [2, 29, 30], including those in the 18–34 bracket [31].…”

Section: Discussionmentioning

confidence: 99%

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Disability perceived by primary care patients with posterior canal benign paroxysmal positional vertigo

et al. 2019

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BackgroundBenign paroxysmal positional vertigo (BPPV) is the most common cause of vertigo. Little is known on how posterior canal BPPV affects health-related quality of life in patients diagnosed and treated at primary care facilities or on whether patients with subjective and objective disease perceive the effects differently. This study was designed to describe how patients diagnosed with posterior canal BPPV in primary care perceive disability.MethodsCross-sectional descriptive study performed at two urban primary care centers. Participants were patients aged 18 years or older with suspected posterior canal BPPV recruited for baseline evaluation in a clinical trial on the effectiveness of the Epley maneuver in primary care. The recruitment period was from November 2012 to January 2015. Perceived disability was evaluated using the Dizziness Handicap Inventory – Screening version (DHI-S). Other variables collected were age and sex, a history or diagnosis of anxiety or depression, treatment with antidepressants and/or anxiolytics, and results of the Dix-Hallpike (DH) test, which was considered positive when it triggered vertigo with or without nystagmus and negative when it triggered neither.ResultsThe DH test was positive in 134 patients, 40.30% of whom had objective BPPV (vertigo with nystagmus). The median age of the patients was 52 years (interquartile range [IQR], 39.00–68.50 years) and 76.1% were women. The median total score on the DHI-S was 16 out of 40 (IQR, 8.00–22.00). Scores were higher (greater perceived disability) in women (p < 0.001) and patients with subjective BPPV (vertigo without nystagmus) (p = 0.033). The items perceived as causing the greatest disability were feeling depressed (67.1%) and worsening of the condition on turning over in bed (88%).ConclusionsPatients diagnosed with posterior canal BPPV in primary care perceive their condition as a disability according to DHI-S scores, with higher levels of disability reported by women and patients with subjective BPPV. Feelings of depression and turning over in bed were associated with the greatest perceived difficulties.Trial registrationClinicalTrials.gov Identifier: NCT01969513. Retrospectively registered. First Posted: October 25, 2013. https://clinicaltrials.gov/ct2/show/NCT01969513

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Section: Discussionsupporting

confidence: 94%

Section: Discussionmentioning

confidence: 60%

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Disability perceived by primary care patients with posterior canal benign paroxysmal positional vertigo

et al. 2019

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“…Also supporting previous ndings [2] [20] [33] [34], women outnumbered men in our study, which is consistent with the higher prevalence of pc-BPPV in women [35] [36][37] [38]. No signi cant differences between men and women were found in terms of response to the EM during follow-up, even though baseline DHI-S scores were higher among women.…”

Section: Discussionsupporting

confidence: 92%

A single Epley manoeuvre can improve self-perceptions of disability (quality of life) in patients with cp-BPPV: A randomised controlled trial in primary care.

Muñoz

Moreno

Balboa

et al. 2020

Preprint

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Background: Posterior canal benign paroxysmal positional vertigo (pc-BPPV) causes physical, functional, and emotional impairment. The treatment of choice is the Epley manoeuvre (EM). The purpose of the study was to compare the impact of the EM and a sham manoeuvre in primary care on self-perceived disability. Method: Randomised, double-blind, sham-controlled clinical trial conducted in primary care with a follow-up of 1 year. Patients aged ≥18 years old diagnosed with pc-BPPV according to the Dix-Hallpike test (DHT) were randomised to an intervention (EM) group or a control (sham manoeuvre) group. The main study covariables were age, sex, history of depression and anxiety, presence of nystagmus in the DHT, patient-perceived disability assessed with the Dizziness Handicap Inventory-screening version (DHI-S). Data were analyzed using bivariate and multivariate mixed Tobit analyses. Results: Overall, 134 patients were studied: 66 in the intervention group and 68 in the control group. Median age was 52 years (interquartile range [IQR], 38.25–68.00 years) and 76.12% of the patients were women. The DHT triggered nystagmus in 40.30% of patients. The median total DHI-S score for the overall sample at baseline was 16 (IQR, 8.00–22.00); 16 [IQR, 10.5–24.0] vs 10 [6.0–14.0] for women vs men ( P <0.001) and 16 [IQR, 10.0-24.0] vs 12 [IQR, 8.0–18.0] for patients without nystagmus vs those with nystagmus ( P =0.033).Patients treated with the EM experienced a mean reduction of 2.03 points in DHI-S score over the follow-up period compared with patients in the sham group. Conclusion: Pc-BPPV affects the quality of life of primary care patients. A single EM can improve self-perceptions of disability by around 2 points on the DHI-S scale, Trial registration : ClinicalTrials.gov Identifier: NCT01969513. Retrospectively registered. First Posted: October 25, 2013. https://clinicaltrials.gov/ct2/show/NCT01969513

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“…In particular, patients with episodic vestibular symptoms may be oligosymptomatic or asymptomatic at the time of ED presentation, thus complicating the diagnosis. Given the considerable impact vestibular symptoms have on quality of life [ 27 – 29 ], ED physicians should strive to identify possibly treatable aetiologies as early as possible to minimize the likelihood of their becoming chronic. Owing to the retrospective nature of the study, and because there was often no assessment by an ENT physician, it is possible that incomplete hearing loss was missed by physicians and misinterpreted by patients as aural fullness.…”

Section: Discussionmentioning

confidence: 99%

Characteristics and resource needs in patients with vestibular symptoms: a comparison of patients with symptoms of unknown versus determined origin

et al. 2020

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Background: Vestibular symptoms are a frequent reason for presenting at the emergency department (ED). Underlying conditions range in severity from life-threatening to benign, but often remain undiagnosed despite extensive investigations. We aimed to identify clinical characteristics that are associated with ED consultations by patients with vestibular symptoms of unknown origin (VUO) and to quantify the ED resources consumed during the investigations. Methods: This retrospective one-year, single-centre, cross-sectional study assessed ED consultations with patients whose chief complaint was 'vestibular symptoms'. Data on risk factors, clinical characteristics, management and ED resources were extracted from the administrative database and medical records. Consultations were grouped according to the discharge diagnosis as either VUO or non-VUO. We determined clinical factors associated with VUO and compared ED resource consumption by the two patient groups using multivariable analysis. Results: A total of 1599 ED consultations were eligible. Of these, 14.3% (n = 229) were consultations with patients with VUO. Clinical characteristics included in the final multivariable model to determine associations with VUO were sensory disorders, aural fullness, improvement at rest, absence of situational provocation, pre-existing neurological conditions, and age < 65 years. Patients with VUO had higher total ED resource consumption in terms of physicians' work and radiology resources, as a result of more use of computed tomography and magnetic resonance imaging. Conclusion: One in seven emergency patients with vestibular symptoms is dismissed without a diagnosis. Clinical characteristics of VUO patients are distinct from patients in whom a diagnosis was made in the ED. VUO triggers higher ED resource consumption, which can be justified if appropriately indicated.

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Health-related quality of life and disability in patients with acute unilateral peripheral vestibular disorders

Abstract: The Dizziness Handicap Inventory and the SF-36 are useful, proved practical and valid instruments for assessing the impact of dizziness on the quality of life of patients with unilateral peripheral vestibular disorders.

Cited by 17 publications

References 20 publications

Disability perceived by primary care patients with posterior canal benign paroxysmal positional vertigo

Disability perceived by primary care patients with posterior canal benign paroxysmal positional vertigo

A single Epley manoeuvre can improve self-perceptions of disability (quality of life) in patients with cp-BPPV: A randomised controlled trial in primary care.

Characteristics and resource needs in patients with vestibular symptoms: a comparison of patients with symptoms of unknown versus determined origin

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