Clinical Report: Stroke Risk Assessment in Patients with Acute Persistent Vertigo

Overview

This study developed and internally validated a multivariable predictive model for assessing stroke risk in patients with acute persistent vertigo. The model demonstrated superior performance compared to existing scoring systems.

Background

Acute persistent vertigo can indicate a stroke, yet effective risk assessment remains challenging. Timely identification of strokes in patients presenting with vertigo is crucial for optimizing treatment and improving outcomes. Current scoring systems often lack the necessary sensitivity and specificity for this patient population.

Data Highlights

Key Findings

• The multivariable model showed excellent discrimination with an AUC of 0.902.
• Stroke event rates were 2.6%, 10.5%, and 58.7% in low-, intermediate-, and high-risk groups, respectively.
• Older age, smoking, hypertension, and diabetes were significant predictors of stroke risk.
• The model outperformed existing scoring systems such as ABCD2 and Triage-Plus.
• Calibration metrics indicated good model performance with a Brier score of 0.096.

Clinical Implications

The developed predictive model may assist in stratifying stroke risk in patients with acute persistent vertigo.

Conclusion

The multivariable prediction model offers a method for stroke risk assessment in acute persistent vertigo.

Related Resources & Content

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5. Guidelines for reasonable and appropriate care in the emergency department 3 (GRACE-3): Acute dizziness and vertigo in the emergency department - PubMed
6. Consensus paper on the management of acute isolated vertigo in the emergency department | Internal and Emergency Medicine | Springer Nature Link
7. Deep-learning–based non-contrast CT for detecting acute ischemic stroke: a systematic review and HSROC meta-analysis of patient-level diagnostic accuracy | BMC Neurology | Springer Nature Link
8. Guidelines for reasonable and appropriate care in the emergency department 3 (GRACE-3): Acute dizziness and vertigo in the emergency department - PubMed
9. Consensus paper on the management of acute isolated vertigo in the emergency department | Internal and Emergency Medicine | Springer Nature Link
10. Deep-learning–based non-contrast CT for detecting acute ischemic stroke: a systematic review and HSROC meta-analysis of patient-level diagnostic accuracy | BMC Neurology | Springer Nature Link