ORIGINAL ARTICLESpectrum of Dizziness Visits to US Emergency Departments: Cross-Sectional Analysis From a Nationally Representative Sample
Section snippets
PATIENTS AND METHODS
This cross-sectional study of US ED patients with dizziness analyzed public-use data from NHAMCS sampled from all US ED visits occurring between January 1, 1993, and December 31, 2005. Study years (1993-2005) were determined on the basis of data availability. NHAMCS is a 4-stage probability sample of visits to randomly selected US hospitals, including noninstitutional general and short-stay hospitals but excluding federal, military, and Veterans Affairs hospitals.11 NHAMCS data are gathered
RESULTS
The total 13-year sample of dizziness cases was 9472, yielding a weighted estimate of 33.6 million ED visits nationally over that same period. This estimate corresponds to 2.6 million visits annually in the United States and 3.3% of all ED visits during that period. Among these, 92% were coded with dizziness as a presenting symptom (Figure 1). There was a bimodal age distribution for ED dizziness visits with a small peak in the third decade and an escalatingfrequency among those 50 years and
DISCUSSION
Our study demonstrates that dizziness is an extremely common ED symptom that preferentially affects older adults. We confirm prior literature that suggests the mostfrequent diagnostic category is oto-vestibular; however, our results also indicate general medical diagnoses are prevalent in this acute care population, and the proportion harboring a dangerous underlying disorder is high. Resource use for dizziness is disproportionate, particularly for diagnostic imaging, yet many patients leave
CONCLUSION
There are roughly 2.6 million visits for dizziness in the United States annually. Emergency department patients with dizziness tend to be older and to use more medical resources than their counterparts without dizziness. They do not conform to traditional textbook notions of “the dizzy patient.” Dizziness is not attributed to a vestibular disorder in most cases and is often associated with cardiovascular or other medical causes. Dangerous disorders are frequently identified, even among younger
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This study was supported principally by the National Institutes of Health, National Center for Research Resources (NCRR) grant K23 RR 17324-01.