Long‐Term Survival in 1,931 Patients With Dizziness: Disease‐ and Symptom‐Specific Mortality

Berge, Jan Erik; Nordahl, Stein Helge Glad; Aarstad, Hans Jørgen; Goplen, Frederik Kragerud

doi:10.1002/lary.29465

Cited by 3 publications

(2 citation statements)

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“…Moreover, the patients had a mean age of 79 years at inclusion, which is considerably higher than in our study. The finding by van Vugt et al (20) that patients with vertigo had lower mortality than those with dizziness of other types is interesting, and agrees with a previous study from our group (7). In the latter study, patientreported unsteadiness between dizziness episodes was associated with higher mortality.…”

Section: Discussionsupporting

confidence: 91%

“…Patients suffering from dizziness or vertigo are often found to have benign disorders of the peripheral vestibular system (6), and severe underlying conditions have, to some extent, been ruled out by referring physicians (7). Nevertheless, a considerable proportion suffers from disorders of unclear or complex etiology, and some may have more serious underlying disorders including cerebrovascular disease.…”

Section: Introductionmentioning

confidence: 99%

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The Romberg sign, unilateral vestibulopathy, cerebrovascular risk factors, and long-term mortality in dizzy patients

Berge

Goplen²,

Aarstad³

et al. 2022

Front. Neurol.

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ObjectivesDescribe the relationship between unsteadiness, canal paresis, cerebrovascular risk factors, and long-term mortality in patients examined for dizziness of suspected vestibular origin.Study designObservational cohort with prospective collection of survival data.SettingUniversity clinic neurotological unit.PatientsConsecutive patients aged 18–75 years examined in the period 1992–2004 for dizziness of suspected vestibular origin.Outcome measuresOverall survival. Standardized mortality ratio (SMR). Factors: Unsteadiness, canal paresis, age, sex, patient-reported diabetes, hypertension, heart disease, stroke, or TIA/minor stroke. Patients were classified as steady or unsteady based on static posturography at baseline compared to normative values.ResultsThe study included 1,561 patients with mean age 48 years and 60 % females. Mean follow-up was 22 years. Unsteadiness was associated with higher age, heart disease, diabetes, hypertension, and cerebrovascular dizziness. There were 336 deaths over 31,335 person-years (SMR 0.96; 95 % confidence interval: 0.86–1.07). Canal paresis was not related to unsteadiness (chi square: p = 0.46) or to mortality (unadjusted Cox hazard ratio: 1.04, 95% CI: 0.80–1.34). Unsteadiness was an independent predictor of mortality (adjusted Cox hazard ratio: 1.44, 95% CI: 1.14–1.82).ConclusionsUnsteadiness measured by static posturography is associated with higher age, known cerebrovascular risk factors, and with increased long-term mortality, but not with canal paresis in patients evaluated for dizziness. The study highlights the importance of evaluating patients with conspicuous postural instability for non-vestibular causes.

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Section: Discussionsupporting

confidence: 91%

Section: Introductionmentioning

confidence: 99%

The Romberg sign, unilateral vestibulopathy, cerebrovascular risk factors, and long-term mortality in dizzy patients

Berge

Goplen²,

Aarstad³

et al. 2022

Front. Neurol.

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Hearing, Balance, and Mortality: Sex‐Specific Patterns in a Longitudinal Study

Berge,

Nilsen,

Goplen

et al. 2024

Otolaryngol.--head neck surg.

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ObjectivesAssess the association of hearing on sex‐specific overall mortality and death from acute cardiovascular disease and evaluate if these effects are modulated by postural balance.Study DesignCohort study.SettingOtolaryngology department at an academic hospital.MethodsPatients underwent standard clinical examination, laboratory examination including stabilometry and audiometry. Pure tone average on the best hearing ear was calculated from 0.5, 1, 2, and 3 kHz. Cause of death was retrieved from the Norwegian Cause of Death Registry.ResultsA total of 1036 patients (58.8% women) were followed for 26 ± 3 years. In Cox regression analyses for overall mortality adjusted for age, past medical history, and vestibular disease, 10 dB increase in hearing threshold was associated with a 14% increase in mortality among men (hazard ratio 95% confidence interval: 1.02‐1.28, P = .02), but no significant association was seen between hearing and mortality in women (0.92‐1.15, P = .60). The same analyses for acute cardiovascular death found that a 10 dB increase in hearing threshold was associated with a 57% increase in hazard ratio in men (1.21‐2.05, P < .001), but no significant effect of hearing on survival was seen in women (P = .71). Adjusting for postural balance did not change the association between hearing and mortality.ConclusionThis study finds hearing threshold is associated with overall mortality and acute cardiovascular death among men, with no such association observed among women. Our findings indicate important differences between men and women and suggest that such differences should be taken into consideration in audiological research.

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Epidemiology of patients with dizziness over a 3-year period, requiring utilization of the emergency medical serviced system: A pre- and post-COVID pandemic comparative study using the population-based ORION registry

Ota

Nishioka

Katayama³

et al. 2023

VES

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OBJECTIVE: We aimed to identify the proportion of each medical condition or disease contributing to dizziness and their disposition in the Emergency Department (ED). METHODS: This retrospective, descriptive study examined data from the Osaka Emergency Information Research Intelligent Operation Network system in Japan for the period from January 1, 2018 to December 31, 2020. The inclusion criteria were patients with presumptive ICD-10 codes including “dizziness” or “vertigo”. Patient demographics were compared using the χ 2 test and Kruskal-Wallis test. Logistic regression analysis was performed to calculate disposition from ED (emergency admission or discharge) over the 3-year study period. The adjusted odds ratio (OR) and 95% confidence interval (CI) were calculated using multivariate analyses. RESULTS: During the 3-year study period, a total of 1,346,457 patients (462,773 in 2018, 468,697 in 2019, and 414,987 in 2020; P < 0.001), including 53,190 patients with dizziness (18,396 in 2018, 18,649 in 2019, and 16,145 in 2020; P = 0.058), were identified as having been transported to hospitals by ambulance in Osaka Prefecture. Dizziness and giddiness (R42) was the most common form of dizziness, in 27,075 cases (9,570 in 2018, 9,613 in 2019, and 7,892 in 2020; P < 0.001; Gender composition showed 10,483 males and 16,592 females.) Vestibular Neuronitis (H81.2) showed significant increase in 2020 compared to the two preceding years (91 in 2018, 119 in 2019, and 130 in 2020, P = 0.003; including 174 males and 167 females, respectively). Of the 53,190 patients with dizziness, 11,862 (22.3% ; 4,323 males, 7,539 females) were admitted to hospital. The odds ratio (OR) for emergency admission for dizziness in 2020 during the COVID-19 pandemic was 0.98 (95% confidence interval (CI), 0.93– 1.03) with reference to 2018. CONCLUSION: Patients with dizziness accounted approximately 4% of ED transportations, with about 20% requiring hospital admission, irrespective of the COVID-19 pandemic. Vestibular neuronitis was significantly increased in 2020.

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Long‐Term Survival in 1,931 Patients With Dizziness: Disease‐ and Symptom‐Specific Mortality

Cited by 3 publications

References 24 publications

The Romberg sign, unilateral vestibulopathy, cerebrovascular risk factors, and long-term mortality in dizzy patients

The Romberg sign, unilateral vestibulopathy, cerebrovascular risk factors, and long-term mortality in dizzy patients

Hearing, Balance, and Mortality: Sex‐Specific Patterns in a Longitudinal Study

Epidemiology of patients with dizziness over a 3-year period, requiring utilization of the emergency medical serviced system: A pre- and post-COVID pandemic comparative study using the population-based ORION registry

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