Universität zu Köln

Mueller, Martin, Goeldlin, Martina B., Gaschen, Janika, Sauter, Thomas C., Stock, Stephanie, Wagner, Franca, Exadaktylos, Aristomenis K., Fischer, Urs, Kalla, Roger and Mantokoudis, Georgios ORCID: 0000-0003-2268-7811 (2020). Characteristics and resource needs in patients with vestibular symptoms: a comparison of patients with symptoms of unknown versus determined origin. BMC Emerg. Med., 20 (1). LONDON: BMC. ISSN 1471-227X

Full text not available from this repository.

Abstract

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.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Mueller, Martin UNSPECIFIED UNSPECIFIED UNSPECIFIED Goeldlin, Martina B. UNSPECIFIED UNSPECIFIED UNSPECIFIED Gaschen, Janika UNSPECIFIED UNSPECIFIED UNSPECIFIED Sauter, Thomas C. UNSPECIFIED UNSPECIFIED UNSPECIFIED Stock, Stephanie UNSPECIFIED UNSPECIFIED UNSPECIFIED Wagner, Franca UNSPECIFIED UNSPECIFIED UNSPECIFIED Exadaktylos, Aristomenis K. UNSPECIFIED UNSPECIFIED UNSPECIFIED Fischer, Urs UNSPECIFIED UNSPECIFIED UNSPECIFIED Kalla, Roger UNSPECIFIED UNSPECIFIED UNSPECIFIED Mantokoudis, Georgios UNSPECIFIED orcid.org/0000-0003-2268-7811 UNSPECIFIED
URN:	urn:nbn:de:hbz:38-322343
DOI:	10.1186/s12873-020-00361-8
Journal or Publication Title:	BMC Emerg. Med.
Volume:	20
Number:	1
Date:	2020
Publisher:	BMC
Place of Publication:	LONDON
ISSN:	1471-227X
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language US EMERGENCY-DEPARTMENTS; CROSS-SECTIONAL ANALYSIS; DIZZINESS PRESENTATIONS; DIAGNOSING DIZZINESS; COMPUTED-TOMOGRAPHY; VERTIGO; QUALITY; BURDEN; COST Multiple languages Emergency Medicine Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/32234