Dizziness and the Acute Vestibular Syndrome at the Emergency Department: A Population-Based Descriptive Study

Is your hospital correctly identifying stroke patients that come in presenting dizziness? You need to know the answer prior to your need for it. In other words; How competent is your ER department? Bad research here since they don't specify the accuracy of the various causes.
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Ljunggren M, Persson J, Salzer J; European Neurology 79 (1-2), 5-12 (Nov 2017)

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BACKGROUND Dizziness is a common occurrence witnessed at emergency departments (EDs). This study aims to describe the epidemiology and management of dizzy patients with and without an acute vestibular syndrome (AVS) in the ED at Umeå University Hospital.
METHODS A total of n = 2,126 ED dizziness visits during 3 years were identified. Data were obtained through retrospective review of medical records. Cases were stratified based on presentation, including AVS and neurological deficits. The outcomes analyzed included cerebrovascular causes of dizziness. A Poisson distribution was assumed when calculating incidence CIs.
RESULTS Dizziness accounted for 2.1% of all ED visits, incidence 477/100,000 inhabitants (95% CI 457-498). Among dizzy patients, 19.2% had an AVS, incidence 92/100,000 inhabitants (95% CI 74-113). Top medical diagnostic groups were otovestibular (15.1%), cardiovascular (8.7%) and neurological diseases (7.7%), including stroke and transitory ischemic attack (4.8%). Cerebrovascular causes of dizziness were more common among those with an AVS (10.0%) vs. those without (3.6%), p <0.01.
CONCLUSION The risk for cerebrovascular causes of dizziness, although low in an unselected cohort, increases with the presence of neurological signs and an AVS. These population-based data may be useful when planning and implementing dizziness and AVS management algorithms at EDs.