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The following is a summary of “Development of a Clinical Risk Score to Risk Stratify for a Serious Cause of Vertigo in Patients Presenting to the Emergency Department,” published in the August 2024 issue of Emergency Medicine by Ohle et al.
Researchers conducted a retrospective study to assess the clinical symptoms of patients with vertigo in the ED and clinical risk score to identify patients with high- and low risk for a severe cause of vertigo.
They conducted a cohort study for 3 years at university-affiliated tertiary care EDs. Patients with vertigo, dizziness, or imbalance were analyzed. The primary outcomes measured were stroke, transient ischemic attack, vertebral artery dissection, or brain tumor.
The results showed 2,078 patients, 2,618 were eligible (79.4%) with a mean age of 77.1 years, and 59% were women. Serious events were in 111 (5.3%) patients. A logistic regression was used for different models such as male, age over 65, hypertension, diabetes, motor/sensory deficits, cerebellar signs/symptoms, and benign paroxysmal positional vertigo diagnosis (C-statistic 0.96, 95% CI 0.92 to 0.98). The risk of a severe diagnosis ranged from 0% for a score of <5, 2.1% for a score of 5 to 8, and 41% for a score >8. Sensitivity for a severe diagnosis was 100% (95% CI, 97.1% to 100%), and specificity 72.1% (95% CI, 70.1% to 74%) for a score <5.
They concluded that the Sudbury Vertigo Risk Score identifies the seriousness of patients with vertigo; on validation it could help physicians in investigations, consultations, and treatment decisions, improving resource utilization and reducing missed diagnoses.
Source: annemergmed.com/article/S0196-0644(24)00326-3/fulltext#%20
