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首页> 外文期刊>Journal of stroke and cerebrovascular diseases: The official journal of National Stroke Association >Predictors of vertigo in the emergency department: The preved study
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Predictors of vertigo in the emergency department: The preved study

机译：急诊部门眩晕预测因素：预测研究

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Background and Purpose: Acute vertigo (sense of motion) can be the sole manifestation of a posterior circulation stroke, and often gets missed in the emergency department (ED). The studies for evaluation of central vertigo have focused on physical exam findings, which require expertise and may not be suitable for rapid triage by a nurse in ED or by paramedics. Methods: This cross sectional study included retrospective chart review of patients 18 years of age and older who presented to the Adult ED with acute dizziness or vertigo during the calendar year 2017. All the patients with a diagnosis of central or peripheral vertigo were included in the final analysis. Sensitivity, specificity, Likelihood Ratio of positive result (LR (+)) and Likelihood Ratio of negative result (LR (-)) for central and peripheral vertigo were calculated for risk factors, symptoms and physical examination features. Chi-squared test and univariate logistic regression were used to evaluate statistical correlation and to calculate the prevalence odds ratio (POR). Results: Two hundred and forty nine out of 505 (49.3%) patients presenting with dizziness had vertigo. Of these, 14 had central vertigo and 163 had peripheral vertigo. Statistically significant variables were: constant symptoms of vertigo (p 0.000- POR 8.7, 95% confidence interval (CI) 2.3-33.1), no change in symptoms with head movement (p 0.000- POR 10.2, 95% CI 3.0-35.4), dysmetria (p 0.000- POR 56.8, 95% CI 5.8-557.1), and unsteady gait (p 0.000- POR 13.3, 95% CI 3.3-54.3). The sensitivity and specificity to detect central vertigo were 100% and 66.4% respectively if the patient had either unsteady gait, constant symptoms, or no change in symptoms with head movement, [VAIN triad (Vertigo- Ataxia, Incessant, or Non-positional)]. Conclusions: We suggest that triage with VAIN triad can be used to design prospective studies to develop a triage algorithm for the detection of central vertigo in the ED. (c) 2020 Elsevier Inc. All rights reserved.
机译：背景和目的：急性眩晕（运动感）可能是后循环中风的唯一表现，在急诊科（ED）经常被忽略。评估中枢性眩晕的研究主要集中在体检结果上，这需要专业知识，可能不适合急诊科护士或护理人员进行快速分诊。方法：这项横断面研究包括对2017日历年期间18岁及以上急性眩晕或眩晕患者的回顾性图表回顾。所有诊断为中枢性或周围性眩晕的患者都被纳入最终分析。计算中枢性和周围性眩晕的敏感性、特异性、阳性结果的似然比（LR（+））和阴性结果的似然比（LR（-）），以确定危险因素、症状和体检特征。采用卡方检验和单变量logistic回归评估统计相关性，并计算患病率优势比（POR）。结果：505例患者中有249例（49.3%）出现眩晕。其中14人有中枢性眩晕，163人有外周性眩晕。具有统计学意义的变量包括：眩晕的持续症状（P0.000-POR 8.7，95%置信区间（CI）2.3-33.1），头部运动时症状无变化（P0.000-POR 10.2，95%CI 3.0-35.4），测量困难（P0.000-POR 56.8，95%CI 5.8-557.1），以及步态不稳（P0.000-POR 13.3，95%CI 3-54.3）。如果患者步态不稳、症状持续或头部运动时症状无变化，[虚荣三联征（眩晕-共济失调、持续性或非体位性）]，则检测中枢性眩晕的敏感性和特异性分别为100%和66.4%。结论：我们建议，在ED（c）2020 Elsevier Inc.中，利用无效三分法进行的分诊可用于设计前瞻性研究，以开发用于检测中枢性眩晕的分诊算法。版权所有。

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