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Characteristics and resource needs in patients with vestibular symptoms: a comparison of patients with symptoms of unknown versus determined origin

BACKGROUND: Vestibular symptoms are a frequent reason for presenting at the emergency department (ED). Underlying conditions range in severity from life-threatening to benign, but often remain undiagnosed despite extensive investigations. We aimed to identify clinical characteristics that are associ...

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Autores principales: Müller, Martin, Goeldlin, Martina B., Gaschen, Janika, Sauter, Thomas C., Stock, Stephanie, Wagner, Franca, Exadaktylos, Aristomenis K., Fischer, Urs, Kalla, Roger, Mantokoudis, Georgios
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7460761/
https://www.ncbi.nlm.nih.gov/pubmed/32867677
http://dx.doi.org/10.1186/s12873-020-00361-8
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author Müller, Martin
Goeldlin, Martina B.
Gaschen, Janika
Sauter, Thomas C.
Stock, Stephanie
Wagner, Franca
Exadaktylos, Aristomenis K.
Fischer, Urs
Kalla, Roger
Mantokoudis, Georgios
author_facet Müller, Martin
Goeldlin, Martina B.
Gaschen, Janika
Sauter, Thomas C.
Stock, Stephanie
Wagner, Franca
Exadaktylos, Aristomenis K.
Fischer, Urs
Kalla, Roger
Mantokoudis, Georgios
author_sort Müller, Martin
collection PubMed
description BACKGROUND: Vestibular symptoms are a frequent reason for presenting at the emergency department (ED). Underlying conditions range in severity from life-threatening to benign, but often remain undiagnosed despite extensive investigations. We aimed to identify clinical characteristics that are associated with ED consultations by patients with vestibular symptoms of unknown origin (VUO) and to quantify the ED resources consumed during the investigations. METHODS: This retrospective one-year, single-centre, cross-sectional study assessed ED consultations with patients whose chief complaint was ‘vestibular symptoms’. Data on risk factors, clinical characteristics, management and ED resources were extracted from the administrative database and medical records. Consultations were grouped according to the discharge diagnosis as either VUO or non-VUO. We determined clinical factors associated with VUO and compared ED resource consumption by the two patient groups using multivariable analysis. RESULTS: A total of 1599 ED consultations were eligible. Of these, 14.3% (n = 229) were consultations with patients with VUO. Clinical characteristics included in the final multivariable model to determine associations with VUO were sensory disorders, aural fullness, improvement at rest, absence of situational provocation, pre-existing neurological conditions, and age < 65 years. Patients with VUO had higher total ED resource consumption in terms of physicians’ work and radiology resources, as a result of more use of computed tomography and magnetic resonance imaging. CONCLUSION: One in seven emergency patients with vestibular symptoms is dismissed without a diagnosis. Clinical characteristics of VUO patients are distinct from patients in whom a diagnosis was made in the ED. VUO triggers higher ED resource consumption, which can be justified if appropriately indicated.
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spelling pubmed-74607612020-09-02 Characteristics and resource needs in patients with vestibular symptoms: a comparison of patients with symptoms of unknown versus determined origin Müller, Martin Goeldlin, Martina B. Gaschen, Janika Sauter, Thomas C. Stock, Stephanie Wagner, Franca Exadaktylos, Aristomenis K. Fischer, Urs Kalla, Roger Mantokoudis, Georgios BMC Emerg Med Research Article BACKGROUND: Vestibular symptoms are a frequent reason for presenting at the emergency department (ED). Underlying conditions range in severity from life-threatening to benign, but often remain undiagnosed despite extensive investigations. We aimed to identify clinical characteristics that are associated with ED consultations by patients with vestibular symptoms of unknown origin (VUO) and to quantify the ED resources consumed during the investigations. METHODS: This retrospective one-year, single-centre, cross-sectional study assessed ED consultations with patients whose chief complaint was ‘vestibular symptoms’. Data on risk factors, clinical characteristics, management and ED resources were extracted from the administrative database and medical records. Consultations were grouped according to the discharge diagnosis as either VUO or non-VUO. We determined clinical factors associated with VUO and compared ED resource consumption by the two patient groups using multivariable analysis. RESULTS: A total of 1599 ED consultations were eligible. Of these, 14.3% (n = 229) were consultations with patients with VUO. Clinical characteristics included in the final multivariable model to determine associations with VUO were sensory disorders, aural fullness, improvement at rest, absence of situational provocation, pre-existing neurological conditions, and age < 65 years. Patients with VUO had higher total ED resource consumption in terms of physicians’ work and radiology resources, as a result of more use of computed tomography and magnetic resonance imaging. CONCLUSION: One in seven emergency patients with vestibular symptoms is dismissed without a diagnosis. Clinical characteristics of VUO patients are distinct from patients in whom a diagnosis was made in the ED. VUO triggers higher ED resource consumption, which can be justified if appropriately indicated. BioMed Central 2020-08-31 /pmc/articles/PMC7460761/ /pubmed/32867677 http://dx.doi.org/10.1186/s12873-020-00361-8 Text en © The Author(s) 2020 Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research Article
Müller, Martin
Goeldlin, Martina B.
Gaschen, Janika
Sauter, Thomas C.
Stock, Stephanie
Wagner, Franca
Exadaktylos, Aristomenis K.
Fischer, Urs
Kalla, Roger
Mantokoudis, Georgios
Characteristics and resource needs in patients with vestibular symptoms: a comparison of patients with symptoms of unknown versus determined origin
title Characteristics and resource needs in patients with vestibular symptoms: a comparison of patients with symptoms of unknown versus determined origin
title_full Characteristics and resource needs in patients with vestibular symptoms: a comparison of patients with symptoms of unknown versus determined origin
title_fullStr Characteristics and resource needs in patients with vestibular symptoms: a comparison of patients with symptoms of unknown versus determined origin
title_full_unstemmed Characteristics and resource needs in patients with vestibular symptoms: a comparison of patients with symptoms of unknown versus determined origin
title_short Characteristics and resource needs in patients with vestibular symptoms: a comparison of patients with symptoms of unknown versus determined origin
title_sort characteristics and resource needs in patients with vestibular symptoms: a comparison of patients with symptoms of unknown versus determined origin
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7460761/
https://www.ncbi.nlm.nih.gov/pubmed/32867677
http://dx.doi.org/10.1186/s12873-020-00361-8
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