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.jpg): Failed to open stream: No such file or directory in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 117 J+Stroke+Cerebrovasc+Dis
2018 ; 27
(2
): 472-478
Nephropedia Template TP
gab.com Text
Twit Text FOAVip
Twit Text #
English Wikipedia
Sudden Hearing Loss with Vertigo Portends Greater Stroke Risk Than Sudden Hearing
Loss or Vertigo Alone
#MMPMID29102540
Chang TP
; Wang Z
; Winnick AA
; Chuang HY
; Urrutia VC
; Carey JP
; Newman-Toker DE
J Stroke Cerebrovasc Dis
2018[Feb]; 27
(2
): 472-478
PMID29102540
show ga
BACKGROUND: Because it is unknown whether sudden hearing loss (SHL) in acute
vertigo is a "benign" sign (reflecting ear disease) or a "dangerous" sign
(reflecting stroke), we sought to compare long-term stroke risk among patients
with (1) "SHL with vertigo," (2) "SHL alone," and (3) "vertigo alone" using a
large national health-care database. METHODS: Patients with first-incident SHL
(International Classification of Diseases, Ninth Edition, Clinical Modification
[ICD-9-CM] 388.2) or vertigo (ICD-9-CM 386.x, 780.4) were identified from the
National Health Insurance Research Database of Taiwan (2002-2009). We defined SHL
with vertigo as a vertigo-related diagnosis ±30 days from the index SHL event.
SHL without a temporally proximate vertigo diagnosis was considered SHL alone.
The vertigo-alone group had no SHL diagnosis. All the patients were followed up
until stroke, death, withdrawal from the database, or current end of the database
(December 31, 2012) for a minimum period of 3 years. The hazards of stroke were
compared across groups. RESULTS: We studied 218,656 patients (678 SHL with
vertigo, 1998 with SHL alone, and 215,980 with vertigo alone). Stroke rates at
study end were 5.5% (SHL with vertigo), 3.0% (SHL alone), and 3.9% (vertigo
alone). Stroke hazards were higher in SHL with vertigo than in SHL alone (hazard
ratio [HR], 1.93; 95% confidence interval [CI], 1.28-2.91) and in vertigo alone
(HR, 1.63; 95% CI, 1.18-2.25). Defining a narrower window between SHL and vertigo
(±3 days) increased the hazards. CONCLUSIONS: The combination of SHL plus vertigo
in close temporal proximity is associated with increased subsequent stroke risk
over SHL alone and vertigo alone. This suggests that SHL in patients with vertigo
is not necessarily a benign peripheral vestibular sign.