Stratified analysis of 1419 cases of vertigo/dizziness

Objective To summarize the etiology of vertigo/dizziness to provide evidence for the accurate diagnosis and treatment of vertigo or dizziness. Methods 6450 patients with vertigo/dizziness symptoms visiting the Clinical Center for Vertigo of Air Force General Hospital of PLA from January to December 2016, 1419 diagnosed with vertigo/dizziness by a team of experts who had general practitioners experience were selected for etiology stratified analysis by gender and age. The χ2-test was used to compare the constitution ratio of etiological stratification by sex. Results Top 9 etiological factors of vertigo/dizziness were benign paroxysmal positional vertigo (BPPV; 38.55%, 547/1419), vestibular migraine (VM; 21.92%, 311/1419), vestibular neuritis (VN; 7.89%, 112/1419), Meniere disease (MD; 6.20%, 88/1419), psychic vertigo (PV; 4.65%, 66/1419), hypertension (3.24%, 46/1419), cerebral infarction (PCI; 2.54%, 36/1419), chronic subjectivity vertigo (CSV; 1.83%, 26/1419), sudden deafness with vertigo (SD; 1.48%, 21/1419), and coronary heart disease (CHD; 0.85%, 12/1419). Vestibular peripheral vertigo accounted for 56.03% (795/1419) of all cases, central vertigo accounted for 24.59% (349/1419), vertigo/dizziness caused by systemic disease accounted for 10.50% (149/1419), and unexplained vertigo/dizziness accounted for 8.88% (126/1419). For patients aged between 9-90 years, top 4 etiological factors stratified by age were:<18 age group (n=26): BPPV (0.42%, 6/1419), motion sickness (0.42%, 6/1419), VM (0.35%, 5/1419), and VN (0.21%, 3/1419); 18-44 age group (n=412): BPPV (11.35%, 161/1419), VM (7.26%, 103/1419), VN (2.47%, 35/1419), and MD (1.20%, 17/1419); 45-59 age group (n=548): BPPV (15.01%, 213/1419), VM (8.25%, 117/1419), MD (3.38%, 48/1419), and VN (2.68%, 38/1419); 60-74 age group (n=343): BPPV(10.36%, 147/1419), VM (4.79%, 68/1419), hypertension (2.11%, 30/1419), and VN (2.11%, 30/1419); and 75-90 age group (n=90): PCI (2.54%, 36/1419), BPPV (1.41%, 20/1419), VM (1.27%, 18/1419), and VN (0.42%, 6/1419). The male/female ratio was 1:1.79 among the 1419 patients. PV and unexplained vertigo/dizziness were more common in females (χ2=4.02, 29.94, P=0.044, P<0.001), while hypertension and PCI were more common in males (χ2=17.90, 21.32, P<0.001). Conclusion Vertigo/dizziness is complex, involves many traditional disciplines, and is therefore difficult to diagnose. Etiology, age, and gender stratification rules in a vertigo center may be different from those in other specialist outpatient clinics of vertigo/dizziness, and the integration of statistical information of different subjects and different dimensions obtained will help improve the precision of vertigo/dizziness diagnosis and treatment by specialists and general practitioners. Key words: Vertigo; Etiological analysis; General practice medicine; Accurate diagnosis