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KMID : 0385920120230060799
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Journal of the Korean Society of Emergency Medicine
2012 Volume.23 No. 6 p.799 ~ p.810
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Effect of Emergency Department Video-nystagmography for Patients with Dizziness
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Kim Tae-Gyun
Shin Sang-Do
Park Chang-Bae
Kwak Young-Ho
Kim Joo-Yeong
Jang Ji-Yeon
Hong Won-Pyo
Ha So-Young
Kang Chang-Woo
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Abstract
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Purpose: We evaluated the effects of emergency department (ED)-based video-nystagmography (VNG) testing on consultation with other departments and length of ED stay of patients with dizziness.
Methods: A before-and-after study was performed at a tertiary ED from May 13, 2011 to May 12, 2012. Adult patients (age≥15 years) with dizziness were enrolled, excluding patients with incomplete information. We defined the before- and after-phase according to implanting of the EDbased VNG test. The VNG test was performed by an internship physician supervised by 2nd or 3rd grade emergency medicine residents. Primary outcome was any consultation to other specialty departments and the secondary outcome was the length of stay at the ED. The adjusted odds ratios (ORs) with 95% confidence interval (95% CI) for outcomes by phase were estimated using multivariate logistic regression analysis adjusting for potential co-variates.
Results: Of 1,485 eligible patients, 1,449 patients (male:37.0%, mean age: 59.2±15.5 years) were enrolled (415 in the before-phase and 1,034 in the after-phase). The final diagnosis group was stroke (4.8%), peripheral vestibulopathy (44.9%), other specific disease (29.0%), and non-diagnostic symptom (21.4%). The consultation request was more reduced in the after-phase (38.1%) than the beforephase (52.5%). The LOS was not changed between both phases (7.4±7.5 hours versus 7.4±7.3 hours, p=0.76). The adjusted OR (95% CI) for the consultation of after-phase compared to before-phase was 0.46(0.35, 0.61), while the adjusted OR (95% CI) for LOS was 1.39(0.99, 1.95).
Conclusion: Implementation of ED-based VNG test significantly reduced the consultation with other specialty departments, while LOS was not affected.
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KEYWORD
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Dizziness, Vertigo, Pathologic nystagmus
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