Hospitalization of patients with vertigo and dizziness for acute stroke evaluation

Vertigo and dizziness are a common complaint affecting 15% to over 20% of adults yearly and can reach up to 36% at the age of 70 and 50% at 90 years of age. Stroke is one of the main concerns in the emergency department, although previous studies demonstrated a very low rate of cerebrovascular events in these patients.

To explore the prevalence, demographic and clinical characteristics of the patients who were hospitalized with isolated vertigo and dizziness and were diagnosed with cerebrovascular event.

A retrospective cohort study that included all patients ≥40 years old who were admitted to one of the internal medicine wards of Clalit Health Services affiliated hospitals between 2014 and 2024, with an isolated complaint of vertigo and dizziness and had brain imaging performed during admission. Demographic and clinical characteristics were extracted from the electronic medical record. Specific imaging findings were unavailable for extraction from the database.

Of the 3977 eligible patients, only 2.8% (n = 110) were discharged with a diagnosis of cerebrovascular event. Previous cerebrovascular event, male sex, and past smoking were significantly more common among the cerebrovascular event-discharge group. In a multivariate model, previous cerebrovascular event (OR 17.41, 95% CI 8.37-36.25, p < 0.0001) and past smoking (OR 1.76, 95% CI 1.08-2.86, p = 0.023) were independently associated with a discharge diagnosis of cerebrovascular event.

Further prospective trials, including with younger patients, are needed to better determine risk stratification and the efficacy of hospitalization of patients with isolated vertigo and dizziness for evaluation of cerebrovascular event.