PDF(Pubmed)
Abstract：
Background/Objectives: Benign paroxysmal positional vertigo (BPPV) is the most common cause of recurrent vertigo and the most common peripheral vestibular disorder. It is characterized by intense vertigo triggered by head and position changes. This study investigates the risk of subsequent injury in BPPV patients and the effects of treatment. Methods: A population-based retrospective cohort study was conducted using data from the Longitudinal Health Insurance Database 2005 in Taiwan. Patients with and without BPPV were identified between 2000 and 2017. The study outcomes were diagnoses of all-cause injuries. The Kaplan-Meier method determined the cumulative incidence rates of injury in both cohorts, and a log-rank test analyzed the differences. Cox proportional hazard models calculated each cohort\'s 18-year hazard ratios (HRs). Results: We enrolled 50,675 patients with newly diagnosed BPPV and 202,700 matched individuals without BPPV. During follow-up, 47,636 patients were diagnosed with injuries (13,215 from the BPPV cohort and 34,421 from the non-BPPV cohort). The adjusted HR for injury in BPPV patients was 2.63 (95% CI, 2.49-2.88). Subgroup analysis showed an increased incidence of unintentional and intentional injuries in BPPV patients (aHR 2.86; 95% CI, 2.70-3.13 and 1.10; 95% CI, 1.04-1.21, respectively). A positive dose-response relationship was observed with increasing BPPV diagnoses. Treatment with canalith repositioning therapy (CRT) or medications reduced the risk of injury slightly but not significantly (aHR, 0.78; 95% CI, 0.37-1.29, 0.88; 95% CI, 0.40-1.40, respectively). Conclusions: BPPV is independently associated with an increased risk of injuries. CRT or medications have limited effects on mitigating this risk. Physicians should advise BPPV patients to take precautions to prevent injuries even after treatment.
摘要：
背景/目的：良性阵发性位置性眩晕（BPPV）是复发性眩晕的最常见原因，也是最常见的周围性前庭疾病。它的特征是由头部和位置变化引发的剧烈眩晕。本研究调查了BPPV患者后续损伤的风险和治疗效果。方法：使用台湾2005年纵向健康保险数据库的数据进行了一项基于人群的回顾性队列研究。在2000年至2017年之间确定了有和没有BPPV的患者。研究结果是全因损伤的诊断。Kaplan-Meier方法确定了两个队列中损伤的累积发生率，并通过对数秩检验分析了差异。Cox比例风险模型计算了每个队列的18年风险比(HR)。结果：我们招募了50,675例新诊断的BPPV患者和202,700例无BPPV的匹配个体。随访期间,47,636例患者被诊断为受伤（BPPV队列中的13,215例和非BPPV队列中的34,421例）。BPPV患者损伤的校正HR为2.63（95％CI，2.49-2.88）。亚组分析显示，BPPV患者的意外和故意伤害发生率增加（aHR2.86；95％CI，2.70-3.13和1.10；95％CI，1.04-1.21）。随着BPPV诊断的增加，观察到了正的剂量反应关系。用牙石复位治疗(CRT)或药物治疗轻微但不显著降低损伤风险(aHR,0.78；95%CI，分别为0.37-1.29、0.88；95%CI，分别为0.40-1.40）。结论：BPPV与损伤风险增加独立相关。CRT或药物对减轻这种风险的作用有限。医生应建议BPPV患者采取预防措施，即使在治疗后也要防止受伤。
