title: Increased risk of vascular events in emergency room patients discharged home with diagnosis of dizziness or vertigo: a 3-year follow-up study.
abstract: BACKGROUND
  Dizziness and vertigo symptoms are commonly seen in emergency room (ER). However, these patients are often discharged without a definite diagnosis. Conflicting data regarding the vascular event risk among the dizziness or vertigo patients have been reported. This study aims to determine the risk of developing stroke or cardiovascular events in ER patients discharged home with a diagnosis of dizziness or vertigo.
  
  
  METHODS
  A total of 25,757 subjects with at least one ER visit in 2004 were identified. Of those, 1,118 patients were discharged home with a diagnosis of vertigo or dizziness. A Cox proportional hazard model was performed to compare the three-year vascular event-free survival rates between the dizziness/vertigo patients and those without dizziness/vertigo after adjusting for confounding and risk factors.
  
  
  RESULTS
  We identified 52 (4.7%) vascular events in patients with dizziness/vertigo and 454 (1.8%) vascular events in patients without dizziness/vertigo. ER patients discharged home with a diagnosis of vertigo or dizziness had 2-fold (95% confidence interval [CI], 1.35-2.96; p<0.001) higher risk of stroke or cardiovascular events after adjusting for patient characteristics, co-morbidities, urbanization level of residence, individual socio-economic status, and initially taking medications after the onset of dizziness or vertigo during the first year.
  
  
  CONCLUSIONS
  ER patients discharged home with a diagnosis of dizziness or vertigo were at a increased risk of developing subsequent vascular events than those without dizziness/vertigo after the onset of dizziness or vertigo. Further studies are warranted for developing better diagnostic and follow-up strategies in increased risk patients.
authors.affiliation: Community Medicine Research Center and Institute of Public Health, National Yang-Ming University, Taipei, Taiwan.
authors.forename: Ching-Chih
authors.initials: CC
authors.lastname: Lee
authors.forename: Hsu-Chueh
authors.initials: HC
authors.lastname: Ho
authors.forename: Yu-Chieh
authors.initials: YC
authors.lastname: Su
authors.forename: Brian C-H
authors.initials: BC
authors.lastname: Chiu
authors.forename: Yung-Cheng
authors.initials: YC
authors.lastname: Su
authors.forename: Yi-Da
authors.initials: YD
authors.lastname: Lee
authors.forename: Pesus
authors.initials: P
authors.lastname: Chou
authors.forename: Sou-Hsin
authors.initials: SH
authors.lastname: Chien
authors.forename: Yung-Sung
authors.initials: YS
authors.lastname: Huang
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D004244:Dizziness / Q000150:complications / Q000175:diagnosis*; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D005500:Follow-Up Studies; D006261:Headache / Q000150:complications; D006801:Humans; D008297:Male; D008875:Middle Aged; D010351:Patient Discharge / Q000706:statistics & numerical data*; D011379:Prognosis; D016016:Proportional Hazards Models; D012307:Risk Factors; D013624:Taiwan / Q000453:epidemiology; D014652:Vascular Diseases / Q000150:complications* / Q000453:epidemiology*; D014717:Vertigo / Q000150:complications / Q000175:diagnosis*; D055815:Young Adult