Initial Diagnosis of Patients with Dizziness or Vertigo in the Emergency Room: Study of Diagnostic Accuracy for Dangerous Causes:Study of Diagnostic Accuracy for Dangerous Causes
スポンサーリンク
概要
- 論文の詳細を見る
Object. The purpose of this retrospective study was to better understand the diagnostic accuracy for dangerous causes (DC) of patients with dizziness or vertigo in the emergency room. Methods. Between April 2002 and March 2004, there were 37, 823 patients who visited the emergency center at Aizawa Hospital. Electronic charts of approximately 4000 patients were reviewed to select suitable patients who had DC of dizziness or vertigo. Results. There were 695 patients who visited the emergency center, totally 809 times. Of the 695 patients who complained of dizziness or vertigo at the first visit, 42 patients (6.0%) were diagnosed as having DC after admission and hospitalization. Of the 42 patients, there were 4 patients with cerebral infarction, 15 with cerebellar and brain stem infarction, 7 with cerebellar and brain stem hemorrhage, 6 with bradyarrhythmia, 3 with tachyarrhythmia, 1 with dissecting aortic aneurysm, 2 with heart failure, 3 with anemia (hemoglobin, ≤7), and 1 wiht hepatic encephalopathy, respectively. Sex (male) and age (≥70 years) were significant related variables to diagnose DC. Of the 42 patients, if complete blood cell count, chest X-ray picture, and electrocardiogram had been at first examined at the emergency room, 30 patients (4.3% among 695 patients with symptoms) would not have been diagnosed as having DC. After subsequent brain computed tomography, 21 patients (3.0%) would not have been diagnosed. Although magnetic resonance imaging had been further examined, still 5 patients (0.7%) would not have been diagnosed as having DC, because, for instance, abnormal findings of cerebellar and brain stem infarction or bradyarrhythmia had turned positive after hospitalization. Conclusion. After detailed history and accurate physical/neurological examination, diagnosis of DC for the majority of patients with dizziness or vertigo would be possible. However, in spite of various studies including brain magnetic resonance imaging, still 0.7% of patients who complained of dizziness or vertigo would not have been diagnosed at the emergency room.
- 一般社団法人 日本救急医学会の論文
一般社団法人 日本救急医学会 | 論文
- Emergency Endovascular Repair for a Ruptured Abdominal Aortic Aneurysm Patient
- Degree of injury severity of the traffic accident autopsy cases.
- タイトル無し
- The Effect of Antithrombin III on Cytokine Production in Endotoxemic Rats.
- Antithrombin III Effects on the Production of Vasoactive Substances in Endotoxemic Rats.