NEW YORK (Reuters Health) – Adults who are admitted to the hospital solely because of an acute bout of dizziness are three times more likely to suffer a stroke in the next four years than the general population, suggests new research from Taiwan.

After going home from the hospital, patients with acute isolated vertigo need a comprehensive neurological examination, vascular risk factors survey, and regular follow-up for several years, Dr. Yung-Sung Huang, from Buddhist Dalin Tzu Chi General Hospital in Chiayi, and colleagues advise.

Their study involved 3,021 patients who were hospitalized with a principal diagnosis of vertigo and 3,021 control patients hospitalized for an appendectomy in 2004 (a surrogate for the general population). All study subjects were identified through the National Health Insurance Research Database in Taiwan. Two-thirds of subjects in both groups were older than 45.

By the end of follow up in 2007, 243 strokes had occurred – 185 (6.1%) in the vertigo group and 58 (1.9%) in the control group.

In analyses adjusting for gender, age, comorbid conditions, and other relevant factors, patients who had been hospitalized for acute isolated vertigo had a threefold greater risk of suffering a stroke during the four-year follow up period (hazard ratio, 3.01; P < 0.001). Thirty-five percent of strokes in the vertigo group occurred in the first year after hospital discharge and roughly 62% occurred within the first two years after being sent home. “This suggests that efforts to prevent stroke development should last for several years after the onset of vertigo,” Dr. Huang and colleagues write. The researchers stratified the group with vertigo by the presence or absence of six risk factors: age older than 55 years, male gender, hypertension, diabetes, coronary artery disease and hyperlipidemia. They found that the risk of stroke was much greater in those with three or more of these risk factors (hazard ratio, 5.5) than in those with only one or two risk factors (hazard ratio 3.2) or those without any of the risk factors. In the vertigo group, 18 strokes occurred in the 941 patients with no risk factors (1.9%); 113 occurred in the 1,654 patients with one to two risk factors (6.8%); and 54 strokes occurred in the 426 patients with three or more of the risk factors (12.7%). The researchers conclude that “more attention” should be given to stroke prevention following a hospital stay for acute isolated vertigo. Reference:
Risk of Stroke in Patients Hospitalized for Isolated Vertigo. A Four-Year Follow-Up Study


Stroke 2011;42.