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KMID : 0385920220330040363
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Journal of the Korean Society of Emergency Medicine
2022 Volume.33 No. 4 p.363 ~ p.370
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Usefulness of computed tomography angiography findings for evaluation of patients with dizziness in the emergency department
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Park Ju-Min
Lee Sung-Eun
Lee Seong-Joon
Choi Sang-Chun
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Abstract
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Objective: Dizziness is a common symptom in the emergency department. Identifying central causes, such as acute ischemic stroke (AIS), is essential in patients with dizziness. This study examined the usefulness of computed tomographic angiography (CTA) for the safe disposition of patients with dizziness when brain magnetic resonance imaging (MRI) is difficult to perform.
Methods: This study was a retrospective observational study. Patients who underwent CTA and MRI to determine the cause of dizziness were included in this study between January 2019 and December 2019. Clinical and radiological characteristics, including the CTA findings, were compared in groups with and without AIS in MRI. Univariate and multivariate logistic regression analyses were performed. The area under the receiver operating characteristic curve (AUROC) was assessed.
Results: Three hundred and fifty patients were included in the study. Of these patients, 63 patients had AIS in MRI. The group with AIS was more frequently male (65.1% vs. 44.3%, P=0.003), had dysarthria (9.5% vs. 2.4%, P=0.016), and relevant vertebral or basilar artery stenosis or occlusion on CTA (66.7% vs. 3.5%, P<0.001). In logistic regression, relevant vertebral or basilar artery stenosis or occlusion was significantly associated with AIS in MRI (odds ratio, 47.941; 95% confidence interval, 20.857-110.195; P<0.001). In the receiver operating characteristic curve, the relevant vertebral or basilar artery stenosis or occlusion on CTA was a feasible predictive value for diagnosing AIS (AUROC, 0.816).
Conclusion: This study showed that the CTA findings were feasible for predicting the safety disposition of patients with dizziness when MRI is difficult to perform.
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KEYWORD
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Dizziness, Acute ischemic stroke, Computed tomographic angiography, Magnetic resonance imaging, Emergency department, Safety disposition
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