어지럼증을 주소로 응급실에 내원한 환자의 임상양상 분석
Clinical Analysis of Dizziness Patients Who Visited Emergency Room
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Background and Objectives Dizziness has diverse underlying causes, so the diagnosis ischallenging especially in the emergency room. The aim of this study is to identify clinicalcharacteristics of patients’ complaints of dizziness in the emergency room. Subjects and Method We retrospectively reviewed the medical records of 10367 patientswho visited the emergency room with the chief complaint of dizziness from January 2016 toDecember 2020. Patients’ clinical information including age, sex, final diagnoses, consultingdepartments, treatment results and seasonal incidences were thoroughly assessed. Results Of the total patients who visited the emergency room, 4.64% complained of dizzi-ness. The mean age of patients was 57.6 years old. The most common age group was over 70’s(28.1%). There were 6322 (61.1%) female patients, while 4035 (38.9%) were male patients. Nearly half 4932 (47.6%) of the patients were managed by the emergency department, followedby 3204, who were managed by the department of otolaryngorhinology (30.9%), and 1166(11.2%) managed by the neurology department. The dizziness was classified as peripheral ver-tigo (33.8%), nonspecific dizziness (27.4%), medical conditions (13.9%), central dizziness(11.0%), cardiac dizziness (6.2%), and other miscellaneous causes of trauma, neoplasm andpsychogenic causes (7.7%). In peripheral vertigo, the incidence of BPPV, vestibular neuritis andMeniere’s disease were 23.5%, 8.8% and 0.6%, respectively. Conclusion Peripheral vertigo accounted for the majority for the patients with chief com-plaints of dizziness in the emergency room. As diverse medical conditions may cause dizzi-ness, specialized departments have to be involved in the diagnostic process of dizziness.
Abstract
Background and Objectives Dizziness has diverse underlying causes, so the diagnosis ischallenging especially in the emergency room. The aim of this study is to identify clinicalcharacteristics of patients’ complaints of dizziness in the emergency room. Subjects and Method We retrospectively reviewed the medical records of 10367 patientswho visited the emergency room with the chief complaint of dizziness from January 2016 toDecember 2020. Patients’ clinical information including age, sex, final diagnoses, consultingdepartments, treatment results and seasonal incidences were thoroughly assessed. Results Of the total patients who visited the emergency room, 4.64% complained of dizzi-ness. The mean age of patients was 57.6 years old. The most common age group was over 70’s(28.1%). There were 6322 (61.1%) female patients, while 4035 (38.9%) were male patients. Nearly half 4932 (47.6%) of the patients were managed by the emergency department, followedby 3204, who were managed by the department of otolaryngorhinology (30.9%), and 1166(11.2%) managed by the neurology department. The dizziness was classified as peripheral ver-tigo (33.8%), nonspecific dizziness (27.4%), medical conditions (13.9%), central dizziness(11.0%), cardiac dizziness (6.2%), and other miscellaneous causes of trauma, neoplasm andpsychogenic causes (7.7%). In peripheral vertigo, the incidence of BPPV, vestibular neuritis andMeniere’s disease were 23.5%, 8.8% and 0.6%, respectively. Conclusion Peripheral vertigo accounted for the majority for the patients with chief com-plaints of dizziness in the emergency room. As diverse medical conditions may cause dizzi-ness, specialized departments have to be involved in the diagnostic process of dizziness.
참고문헌 (19)
- 김각, "어지럼을 주소로 응급실로 내원한 1,060예의 임상적 고찰", 대한이비인후-두경부외과학회지, 52(4), pp.302~306 (2009), 대한이비인후과학회
- 김기용, "어지럼을 주소로 응급실에 내원한 환자의 임상적 고찰", Research in Vestibular Science, 10(2), pp.56~62 (2011), 대한평형의학회
- Dieterich M, "Dizziness", Neurologist, 10(3), pp.154~164 (2004)
- 김현아, "현훈 진단에 있어 함정", 대한신경과학회지, 36(4), pp.280~288 (2018), 대한신경과학회[DOI]
- Ryoo JH, "Clinical analysis of the origins of dizziness in patients", J Korean Soc Emerg Med, 12(3), pp.259~267 (2001)
- Kim HJ, "Etiologic distribution of dizziness and vertigo in a referral-based dizziness clinic in South Korea", J Neurol, 267(8), pp.2252~2259 (2020)
- Baloh RW, "Vertigo", Lancet, 352(9143), pp.1841~1846 (1998)
- 이태경, "어지럼 환자의 진단적 접근", 대한의사협회지, 51(11), pp.960~974 (2008), 대한의사협회
- Koelliker P, "Benign paroxysmal positional vertigo : Diagnosis and treatment in the emergency department--a review of the literature and discussion of canalith-repositioning maneuvers", Ann Emerg Med, 37(4), pp.392~398 (2001)
- Zwergal A, "Vertigo and dizziness in the emergency room", Curr Opin Neurol, 33(1), pp.117~125 (2020)
- Mandge V, "Predictors of vertigo in the emergency department : The preved study", J Stroke Cerebrovasc Dis, 29(9), pp.105043~ (2020)
- Garrigues HP, "Epidemiological aspects of vertigo in the general population of the autonomic region of Valencia, Spain", Acta Otolaryngol, 128(1), pp.43~47 (2008)
- Newman-Toker DE, "Spectrum of dizziness visits to US emergency departments : Cross-sectional analysis from a nationally representative sample", Mayo Clin Proc, 83(7), pp.765~775 (2008)
- Saeed BMN, "Climatic variations and benign paroxysmal positional vertigo", J Otol, 11(1), pp.33~37 (2016)
- Mariani P, "Epidemiology of paroxysmal positioning vertigo: Correlation with seasons, climate, and pollution", Int Tinnitus J, 14(2), pp.168~174 (2008)
- 전은주, "Effects of Meteorological Factors on the Onset of Vestibular Neuritis", Research in Vestibular Science, 11(4), pp.116~122 (2012), 대한평형의학회
- Jahn K, "Telling friend from foe in emergency vertigo and dizziness : Does season and daytime of presentation help in the differential diagnosis?", J Neurol, 267(Suppl 1), pp.118~125 (2020)
- Pereira AB, "Seasonality of dizziness and vertigo in a tropical region", Chronobiol Int, 32(5), pp.585~590 (2015)
- Turin TC, "Untreated or uncontrolled cardiovascular risk factors are associated with an increased risk of cerebral hemorrhage during colder periods", Acta Neurol Scand, 121(1), pp.67~69 (2010)