Risk Factors and Risk Model Construction of Stroke in Patients with Vertigo in Emergency Department

Abstract

Objective: We aimed to explore the risk factors of stroke in patients with vertigo in the emergency department and establish a risk prediction model for stroke patients.

Methods: A total of 301 patients experiencing vertigo in our hospital from January 2020 to January 2021 were retrospectively included. Patients were divided into the stroke group (n = 56) and the nonstroke group (n = 245). The clinical characteristics of patients in both groups were collected and compared, followed by binary logistic regression that was employed to determine the risk factors that affect stroke diagnosis. The receiver operating characteristic (ROC) curve was used to clarify the effectiveness of the constructed model.

Results: Patients in the stroke group were older and had higher systolic and diastolic blood pressure on admission than the nonstroke group. Meanwhile, they demonstrated a higher proportion of diabetes and atrial fibrillation and focal muscle weakness, dysarthria, dysphagia, or ataxia in neurological examinations compared to the nonstroke group (all P < 0.05). The proportion of patients in the nonstroke group who had a history of vertigo or inner ear disease was significantly higher than that in the stroke group (P < 0.05). The patient's age ≥ 60 years old (OR = 3.57), diabetes (OR = 4.57), atrial fibrillation (OR = 4.26), previous history of vertigo or inner ear disease (OR = 0.16), focal muscle weakness (OR = 4.34), and dysphagia or ataxia (OR = 4.08) were associated with a higher risk of stroke. The area under the curve for stroke was 0.87, and the sensitivity and specificity were 98.2% and 57.6%, respectively, as the sum of the assigned scores was greater than 3.

Conclusions: Age ≥ 60 years old, diabetes, atrial fibrillation, previous history of vertigo or inner ear disease, focal muscle weakness, dysphagia, or ataxia were associated with a higher risk of stroke. The risk model constructed based on our findings may help to assess the risk of stroke in patients with vertigo in the emergency department.