title: Long-term outcome of vertigo and dizziness associated disorders following treatment in specialized tertiary care: the Dizziness and Vertigo Registry (DiVeR) Study.
abstract: To investigate the long-term outcome of interdisciplinary treatment in a tertiary care neuro-otology institution after 2 years as part of the Dizziness and Vertigo Registry study. Risk factors associated with unfavourable outcome were assessed. 3113 consecutive patients with disorders of vertigo and dizziness were recruited prospectively between March 2010 and February 2012. Patients were clinically assessed and treated according to their diagnosis. Standardized instruments were used at baseline and at 2-year follow-up [Dizziness Handicap Inventory (DHI), Quality of Life Questionnaire, General Depression Scale, Stait-Trait Anxiety Index], as well as a custom health-related questionnaire. The primary outcome variable of this observational study was the change in DHI after 2 years. Patients suffered from phobic postural vertigo (23%), benign peripheral paroxysmal vertigo (14.4%), unilateral vestibulopathy (10.5%), central vestibular disorders (8%), Menière's disease (9.8%), vestibular migraine (6.9%), bilateral vestibulopathy (5.5%), and vestibular paroxysmia (3.1%). Mean disease duration was 4.6 ± 6.3 years. 1272 patients were available for follow-up, 1159 completed the DHI score. 72.1% of patients improved in DHI score from baseline to 2 years follow-up. Mean reduction in DHI score was 14 points (p = 0.02). Long-term outcome following diagnosis and treatment in a specialized tertiary care centre is good and persistent after 2 years. Risk factors for an unfavourable outcome were advanced age, severe disability, constant vertigo or dizziness, and concomitant back pain, while depression and anxiety did not contribute to this risk considerably.
authors.affiliation: Department of Neurology, University of Duisburg-Essen, Hufelandstr. 55, 45147, Essen, Germany. mark.obermann@uni-due.de.|Center for Neurology, Asklepios Hospitals Schildautal, Seesen, Germany. mark.obermann@uni-due.de.
authors.forename: Mark
authors.initials: M
authors.lastname: Obermann
authors.affiliation: Institute for Medical Informatics Biometry and Epidemiology, University of Duisburg-Essen, Essen, Germany. eva.bock@uk-essen.de.
authors.forename: Eva
authors.initials: E
authors.lastname: Bock
authors.affiliation: Department of Neurology, University of Duisburg-Essen, Hufelandstr. 55, 45147, Essen, Germany. n.sabev@yahoo.de.
authors.forename: Nikolay
authors.initials: N
authors.lastname: Sabev
authors.affiliation: Institute for Medical Informatics Biometry and Epidemiology, University of Duisburg-Essen, Essen, Germany. nils.lehmann@uk-essen.de.
authors.forename: Nils
authors.initials: N
authors.lastname: Lehmann
authors.affiliation: Department of Neurology, Alfried-Krupp-Hospital Essen, Essen, Germany. ralph.weber@krupp-krankenhaus.de.
authors.forename: Ralph
authors.initials: R
authors.lastname: Weber
authors.affiliation: Department of Neurology, University of Duisburg-Essen, Hufelandstr. 55, 45147, Essen, Germany. marcus.gerwig@uk-essen.de.
authors.forename: Marcus
authors.initials: M
authors.lastname: Gerwig
authors.affiliation: Department of Neurology, University of Duisburg-Essen, Hufelandstr. 55, 45147, Essen, Germany. markus.frings@uk-essen.de.
authors.forename: Markus
authors.initials: M
authors.lastname: Frings
authors.affiliation: Department of Otorhinolaryngology, University of Duisburg-Essen, Essen, Germany. diana.arweiler-harbeck@uk-essen.de.
authors.forename: Diana
authors.initials: D
authors.lastname: Arweiler-Harbeck
authors.affiliation: Department of Otorhinolaryngology, University of Duisburg-Essen, Essen, Germany. stephan.lang@uk-essen.de.
authors.forename: Stephan
authors.initials: S
authors.lastname: Lang
authors.affiliation: Department of Neurology, University of Duisburg-Essen, Hufelandstr. 55, 45147, Essen, Germany. hans.diener@uk-essen.de.
authors.forename: Hans-Christoph
authors.initials: HC
authors.lastname: Diener
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004244:Dizziness / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008575:Meniere Disease / Q000628:therapy*; D008875:Middle Aged; D011788:Quality of Life; D012042:Registries; D011795:Surveys and Questionnaires; D063128:Tertiary Health Care; D016896:Treatment Outcome; D014717:Vertigo / Q000628:therapy*
keywords: Dizziness; Long-term follow-up; Tertiary care; Treatment centre; Vertigo