Acute dizziness with potential life-threatening event: A case series from single ICU

Article type: Research Article

Authors: Dao-Ming, Tong^{a; *} | Ye-Ting, Zhou^b

Affiliations: [a] Department of Neurology, Affiliated Shuyang Hospital, Xuzhou Medical University, Jiangsu, China | [b] Department of Clinical Research, Affiliated Shuyang Hospital, Xuzhou Medical University, Jiangsu, China

Correspondence: [*] Corresponding author: Dr. Dao-Ming Tong, The Affiliated Shuyang Hospital, Xuzhou Medical University, Xuzhou, No. 9, Yingbin Road, Shucheng, Jiangsu 223600, China. Tel.: +1 0527 8999 0120; Fax: +1 0527 1358 7583; E-mail: [email protected].

Abstract: BACKGROUND:Whether the acute dizziness would be associated with potentially life-threatening event, which was previously unknown. METHODS:Between Jan 2014 and Dec 2016, We performed a retrospective survey to investigate the clinical data of patients with acute dizziness from an intensive care unit (ICU) in China. Inclusion criteria for all cases were presented with acute dizziness at onset, and then with a potentially life-threatening event. Baseline data and 30-days outcomes were collected. RESULTS:Approximately 1.0% of ICU patients had an acute dizziness with potentially life-threatening events. The median age of patients was 60 years (range 23 to 81 years), male: female ratio was 1.8:1. The causes of acute dizziness included focal cerebral hemorrhage in 15 cases (60%), shock in 7cases (28%), and cerebral infarction in 3 cases (12%). The most frequent potentially life-threatening event was acute brain failure (24/25), and the most common cause leading to brain failure was the lesion enlarged (54.2%, including hematoma enlargement in 8 cases, large area infarction or new infarction in 3 cases, and intraventricular hemorrhage in 2 cases). The second potentially life-threatening event was septic shock/secondary sepsis (45.8%). The fatality rate for all life- threatening events was in 64%. Compared with the survival group, the patients with lesion enlarged (56.3% vs. 11.1%, p < 0.05), acute respiratory failure (93.8% vs. 55.6% p < 0.05), lactate level (5.3 mmol/l vs. 1.3 mmol/l, p < 0.05), and Sequential Organ Failure Assessment (SOFA) score (6.9 vs. 3.4, p < 0.0001) in the non-survival group were significantly higher, while late mean arterial blood pressure (84.6 mmHg vs.124 mmHg, p < 0.0001), GCS score (5.0 score vs. 15 score, p < 0.0001) in the non-survival group were significantly lower. CONCLUSION:Acute dizziness with potentially life-threatening events accounts for about 1% of adult ICU patients. Acute dizziness in ICU patients is associated with a high risk of death within 30 days of onset.

Keywords: Acute dizziness or vertigo; life-threatening event, organ dysfunction, prognosis

DOI: 10.3233/VES-190677

Journal: Journal of Vestibular Research, vol. 29, no. 4, pp. 191-196, 2019