The Romberg sign, unilateral vestibulopathy, cerebrovascular risk factors, and long-term mortality in dizzy patients
ObjectivesDescribe the relationship between unsteadiness, canal paresis, cerebrovascular risk factors, and long-term mortality in patients examined for dizziness of suspected vestibular origin.Study designObservational cohort with prospective collection of survival data.SettingUniversity clinic neur...
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| Format: | Article |
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Frontiers Media S.A.
2022-08-01
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| Series: | Frontiers in Neurology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fneur.2022.945764/full |
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| author | Jan Erik Berge Jan Erik Berge Jan Erik Berge Frederik Kragerud Goplen Frederik Kragerud Goplen Frederik Kragerud Goplen Hans Jørgen Aarstad Hans Jørgen Aarstad Tobias Andre Storhaug Tobias Andre Storhaug Stein Helge Glad Nordahl Stein Helge Glad Nordahl |
| author_facet | Jan Erik Berge Jan Erik Berge Jan Erik Berge Frederik Kragerud Goplen Frederik Kragerud Goplen Frederik Kragerud Goplen Hans Jørgen Aarstad Hans Jørgen Aarstad Tobias Andre Storhaug Tobias Andre Storhaug Stein Helge Glad Nordahl Stein Helge Glad Nordahl |
| author_sort | Jan Erik Berge |
| collection | DOAJ |
| description | ObjectivesDescribe the relationship between unsteadiness, canal paresis, cerebrovascular risk factors, and long-term mortality in patients examined for dizziness of suspected vestibular origin.Study designObservational cohort with prospective collection of survival data.SettingUniversity clinic neurotological unit.PatientsConsecutive patients aged 18–75 years examined in the period 1992–2004 for dizziness of suspected vestibular origin.Outcome measuresOverall survival. Standardized mortality ratio (SMR). Factors: Unsteadiness, canal paresis, age, sex, patient-reported diabetes, hypertension, heart disease, stroke, or TIA/minor stroke. Patients were classified as steady or unsteady based on static posturography at baseline compared to normative values.ResultsThe study included 1,561 patients with mean age 48 years and 60 % females. Mean follow-up was 22 years. Unsteadiness was associated with higher age, heart disease, diabetes, hypertension, and cerebrovascular dizziness. There were 336 deaths over 31,335 person-years (SMR 0.96; 95 % confidence interval: 0.86–1.07). Canal paresis was not related to unsteadiness (chi square: p = 0.46) or to mortality (unadjusted Cox hazard ratio: 1.04, 95% CI: 0.80–1.34). Unsteadiness was an independent predictor of mortality (adjusted Cox hazard ratio: 1.44, 95% CI: 1.14–1.82).ConclusionsUnsteadiness measured by static posturography is associated with higher age, known cerebrovascular risk factors, and with increased long-term mortality, but not with canal paresis in patients evaluated for dizziness. The study highlights the importance of evaluating patients with conspicuous postural instability for non-vestibular causes. |
| first_indexed | 2024-04-12T07:44:48Z |
| format | Article |
| id | doaj.art-96eaedcb1264460ca14a1ab74b83d5f5 |
| institution | Directory Open Access Journal |
| issn | 1664-2295 |
| language | English |
| last_indexed | 2024-04-12T07:44:48Z |
| publishDate | 2022-08-01 |
| publisher | Frontiers Media S.A. |
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| series | Frontiers in Neurology |
| spelling | doaj.art-96eaedcb1264460ca14a1ab74b83d5f52022-12-22T03:41:45ZengFrontiers Media S.A.Frontiers in Neurology1664-22952022-08-011310.3389/fneur.2022.945764945764The Romberg sign, unilateral vestibulopathy, cerebrovascular risk factors, and long-term mortality in dizzy patientsJan Erik Berge0Jan Erik Berge1Jan Erik Berge2Frederik Kragerud Goplen3Frederik Kragerud Goplen4Frederik Kragerud Goplen5Hans Jørgen Aarstad6Hans Jørgen Aarstad7Tobias Andre Storhaug8Tobias Andre Storhaug9Stein Helge Glad Nordahl10Stein Helge Glad Nordahl11Norwegian National Advisory Unit for Vestibular Disorders, Haukeland University Hospital, Bergen, NorwayDepartment of Otorhinolaryngology and Head and Neck Surgery, Haukeland University Hospital, Bergen, NorwayDepartment of Clinical Medicine, University of Bergen, Bergen, NorwayNorwegian National Advisory Unit for Vestibular Disorders, Haukeland University Hospital, Bergen, NorwayDepartment of Otorhinolaryngology and Head and Neck Surgery, Haukeland University Hospital, Bergen, NorwayDepartment of Clinical Medicine, University of Bergen, Bergen, NorwayDepartment of Otorhinolaryngology and Head and Neck Surgery, Haukeland University Hospital, Bergen, NorwayDepartment of Clinical Medicine, University of Bergen, Bergen, NorwayDepartment of Clinical Medicine, University of Bergen, Bergen, NorwayDepartment of Anesthesiology and Intensive Care, Vestre Viken Hospital Trust, Drammen, NorwayNorwegian National Advisory Unit for Vestibular Disorders, Haukeland University Hospital, Bergen, NorwayDepartment of Clinical Medicine, University of Bergen, Bergen, NorwayObjectivesDescribe the relationship between unsteadiness, canal paresis, cerebrovascular risk factors, and long-term mortality in patients examined for dizziness of suspected vestibular origin.Study designObservational cohort with prospective collection of survival data.SettingUniversity clinic neurotological unit.PatientsConsecutive patients aged 18–75 years examined in the period 1992–2004 for dizziness of suspected vestibular origin.Outcome measuresOverall survival. Standardized mortality ratio (SMR). Factors: Unsteadiness, canal paresis, age, sex, patient-reported diabetes, hypertension, heart disease, stroke, or TIA/minor stroke. Patients were classified as steady or unsteady based on static posturography at baseline compared to normative values.ResultsThe study included 1,561 patients with mean age 48 years and 60 % females. Mean follow-up was 22 years. Unsteadiness was associated with higher age, heart disease, diabetes, hypertension, and cerebrovascular dizziness. There were 336 deaths over 31,335 person-years (SMR 0.96; 95 % confidence interval: 0.86–1.07). Canal paresis was not related to unsteadiness (chi square: p = 0.46) or to mortality (unadjusted Cox hazard ratio: 1.04, 95% CI: 0.80–1.34). Unsteadiness was an independent predictor of mortality (adjusted Cox hazard ratio: 1.44, 95% CI: 1.14–1.82).ConclusionsUnsteadiness measured by static posturography is associated with higher age, known cerebrovascular risk factors, and with increased long-term mortality, but not with canal paresis in patients evaluated for dizziness. The study highlights the importance of evaluating patients with conspicuous postural instability for non-vestibular causes.https://www.frontiersin.org/articles/10.3389/fneur.2022.945764/fullsurvivalposturographydizzinessvertigovestibular disorderscaloric response |
| spellingShingle | Jan Erik Berge Jan Erik Berge Jan Erik Berge Frederik Kragerud Goplen Frederik Kragerud Goplen Frederik Kragerud Goplen Hans Jørgen Aarstad Hans Jørgen Aarstad Tobias Andre Storhaug Tobias Andre Storhaug Stein Helge Glad Nordahl Stein Helge Glad Nordahl The Romberg sign, unilateral vestibulopathy, cerebrovascular risk factors, and long-term mortality in dizzy patients Frontiers in Neurology survival posturography dizziness vertigo vestibular disorders caloric response |
| title | The Romberg sign, unilateral vestibulopathy, cerebrovascular risk factors, and long-term mortality in dizzy patients |
| title_full | The Romberg sign, unilateral vestibulopathy, cerebrovascular risk factors, and long-term mortality in dizzy patients |
| title_fullStr | The Romberg sign, unilateral vestibulopathy, cerebrovascular risk factors, and long-term mortality in dizzy patients |
| title_full_unstemmed | The Romberg sign, unilateral vestibulopathy, cerebrovascular risk factors, and long-term mortality in dizzy patients |
| title_short | The Romberg sign, unilateral vestibulopathy, cerebrovascular risk factors, and long-term mortality in dizzy patients |
| title_sort | romberg sign unilateral vestibulopathy cerebrovascular risk factors and long term mortality in dizzy patients |
| topic | survival posturography dizziness vertigo vestibular disorders caloric response |
| url | https://www.frontiersin.org/articles/10.3389/fneur.2022.945764/full |
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