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Inpatient Treatment of Patients Admitted for Dizziness: A Population-Based Healthcare Research Study on Epidemiology, Diagnosis, Treatment, and Outcome

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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 age: 61 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.
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Keywords: Dizziness; Guideline adherence; Healthcare research; Investigations; Treatment; Vertigo

Document Type: Research Article

Affiliations: 1: Department of Otorhinolaryngology, Jena University Hospital, Jena 2: Department of Otorhinolaryngology, Zentralklinikum, Suhl 3: Department of Otorhinolaryngology, Südharz-Krankenhaus gGmbH, Nordhausen 4: Department of Otorhinolaryngology, HELIOS-Klinikum, Erfurt 5: Department of Otorhinolaryngology, Sophien/Hufeland-Klinikum, Weimar 6: Department of Otorhinolaryngology, Klinikum Bad Salzungen, Bad Salzungen 7: Department of Otorhinolaryngology, SRH Wald-Klinikum, Gera 8: Department of Otorhinolaryngology, Ilm-Kreis-Kliniken, Arnstadt 9: Hans Berger Department of Neurology, Jena University Hospital, Jena, Germany

Publication date: December 1, 2017

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