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Vertigo and Stroke: A National Database Survey

Huon, Leh-Kiong*; Wang, Ting-Chuan; Fang, Te-Yung*; Chuang, Li-Ju; Wang, Pa-Chun*‡§∥

doi: 10.1097/MAO.0b013e31826426ee
Research Methodology
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Objective To investigate the association between vertigo and stroke in Taiwan using the Bureau of National Health Insurance research database.

Methods Information on adult patients with an index vertigo attack in 2006 was retrieved from Bureau of National Health Insurance research database. All patients with specific diagnostic codes for vertigo were included. Occurrence of stroke during a 1-year follow-up period was identified. Risk factors for stroke were examined. Using χ2 test, t test, and a multilevel logistic regression model, patients with vertigo were categorized into stroke and nonstroke groups for comparative analyses. An age- and sex- matched control cohort was prepared for comparison.

Results Patients with vertigo (n = 527,807) (mean age, 55.1 yr) accounted for 3.1% of the general Taiwanese adult population. The prevalence of stroke among vertigo patients of 0.5% (mean age, 67.8 yr) was slightly higher than that of the control group (0.3%; mean age, 72.3 yr; p < 0.0001). The types of stroke were ischemic (66.7%), nontypical (29.0%), and hemorrhage (4.3%). The prevalence of stroke increased with age (p < 0.001). Patients with vertigo had higher prevalence of comorbid conditions (p < 0.0001); those with diabetes mellitus, hypertension, dyslipidemia, coronary artery disease, or atrial fibrillation had a higher prevalence of stroke (p < 0.001). Hypertension was the most significant predictor of stroke (odds ratio, 3.77; 95% confidence interval, 3.36–4.23; p < 0.001).

Conclusion Patients with vertigo had higher chance to develop stroke than the control group. Some strokes may initially manifest as peripheral vertigo, and some central vertigo may eventually evolve into a stroke. Middle aged male, diabetes, hypertension, dyslipidemia, coronary artery disease, and atrial fibrillation are risk factors for subsequent stroke in vertigo patients.

*Department of Otolaryngology, †Department of Medical Research, Cathay General Hospital; ‡Cathay Medical Research Institute; §Fu Jen Catholic University School of Medicine, Taipei County; and ∥Department of Public Health, College of Public Health, China Medical University, Taichung, Taiwan, Republic of China

Address correspondence and reprint requests to Pa-Chun Wang, M.D., M.Sc., Department of Otolaryngology, Cathay General Hospital, 280, Sec 4. Jen-Ai Rd, 106 Taipei, Taiwan, Republic of China; E-mail: drtony@seed.net.tw

Financial Disclosure: None.

This study is based in part on data from the National Health Insurance research database provided by the Bureau of National Health Insurance, Department of Health, and managed by the National Health Research Institutes. The interpretation and conclusions herein do not represent those of the Bureau of National Health Insurance, Department of Health, or National Health Research Institutes of Taiwan, Republic of China.

© 2012 Otology & Neurotology, Inc.