12. tbl. 102. árg. 2016

Dizziness in the emergency department – do we lack clinical judgment?

Svimi á bráðamóttöku - vantar á okkur klíníska nefið?

Objectives: The aim of this study was to evaluate the extent and quality of work-up of dizzy patients at the Landspitali Emergency department.

Patients and methods: All cases presenting to the emergency department with the main complaint of dizziness over a period of four months were analyzed retrospectively. Demographics, duration of symptoms, diagnosis and results from investigations and consultations were recorded from medical records. Investigations were categorized to blood tests, brain imaging and consultations to simplify interpretation of the results.

Results: One hundred sixty three cases were identified. 28% were diagnosed with inner ear problem and 32% were discharged without diagnosis. A serious central nervous system cause was found in 4% of cases. About one-third underwent investigations from all of the three investigation categories. An acute CT scan of the brain was obtained in 40% and MRI in 17% of all cases. Consultation was obtained from a neurologist for 28%, ENT for 26% and a cardiologist for 2% of cases. 11.6% (n=19) of the patients were admitted to the hospital, 53% to neurology, 42% to internal medicine and 5% to ENT.

Conclusions: Dizziness is a common complaint in the emergency department and the cause is most often benign. Nevertheless, patients with dizziness routinely undergo extensive workup which often includes acute CT scan of the brain.

Figure 1. Extent of the dizziness work up by categories.

Shows the proportion of cases where investigations from one, two or all three categories were used in the work up of patients with dizziness. The figure shows that in almost one third of the cases were all three investigation categories used.

Tables I-VI


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