Risk of Stroke in Patients Hospitalized for Isolated Vertigo A Four-Year Follow-Up Study

Background and Purpose-Vertigo is a common presenting symptom in ambulatory care settings, and stroke is its leading and most challenging concern. This study aimed to determine the risk of stroke in vertigo patients in a 4-year follow-up after hospitalization for acute isolated vertigo. Methods-The study cohorts consisted of all patients hospitalized with a principal diagnosis of vertigo (n = 3021), whereas patients hospitalized for an appendectomy in 2004 (n = 3021) comprised the control group and surrogate for the general population. Cox proportional hazard model was performed as a means of comparing the 4-year stroke-free survival rate between the 2 cohorts after adjusting for possible confounding and risk factors. Among vertigo patients, there was further stratification for risk factors to identify the group at high risk for stroke. Results-Of the 243 stroke patients, 185 (6.1%) were from the study cohort and 58 (1.9%) were from the control group. Comparing the 2 groups, patients with vertigo symptoms had a 3.01-times (95% CI, 2.20-4.11; P < 0.001) higher risk for stroke after adjusting for patient characteristics, comorbidities, geographic region, urbanization level of residence, and socioeconomic status. Vertigo patients with >= 3 risk factors had a 5.51-fold higher risk for stroke (95% CI, 3.10-9.79; P < 0.001) than those without risk factors. Conclusions-Vertigo patients are at higher risk for stroke than the general population. They should have a comprehensive neurological examination, vascular risk factors survey, and regular follow-up for several years after hospital discharge after treatment of isolated vertigo. (Stroke. 2011; 42: 48-52.)