Background: Vestibular symptoms are a frequent reason for presenting at the emergency department (ED).\nUnderlying conditions range in severity from life-threatening to benign, but often remain undiagnosed despite\nextensive investigations. We aimed to identify clinical characteristics that are associated with ED consultations by\npatients with vestibular symptoms of unknown origin (VUO) and to quantify the ED resources consumed during\nthe investigations.\nMethods: This retrospective one-year, single-centre, cross-sectional study assessed ED consultations with patients\nwhose chief complaint was â??vestibular symptomsâ??. Data on risk factors, clinical characteristics, management and ED\nresources were extracted from the administrative database and medical records. Consultations were grouped\naccording to the discharge diagnosis as either VUO or non-VUO. We determined clinical factors associated with\nVUO and compared ED resource consumption by the two patient groups using multivariable analysis.\nResults: A total of 1599 ED consultations were eligible. Of these, 14.3% (n = 229) were consultations with patients\nwith VUO. Clinical characteristics included in the final multivariable model to determine associations with VUO were\nsensory disorders, aural fullness, improvement at rest, absence of situational provocation, pre-existing neurological\nconditions, and age < 65 years. Patients with VUO had higher total ED resource consumption in terms of physiciansâ??\nwork and radiology resources, as a result of more use of computed tomography and magnetic resonance imaging.\nConclusion: One in seven emergency patients with vestibular symptoms is dismissed without a diagnosis. Clinical\ncharacteristics of VUO patients are distinct from patients in whom a diagnosis was made in the ED. VUO triggers\nhigher ED resource consumption, which can be justified if appropriately indicated.
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