Yong Zhao, Xiaonan Fan*, Yun Bai, Juan Ma, Shilin Li
Internal Medicine-Neurology, Xi'an No.3 Hospital, Xi'an, 710018, China
Objective: To analyze the high-risk factors and the clinical diagnostic value of the early warning model in emergency stroke patients with neutral vertigo.
Methods: A total of 352 patients with acute vertigo who were diagnosed and treated in the emergency department of our hospital from January 2019 to January 2020 were collected and divided into a stroke group (n = 85) and a non-stroke group (n = 267). According to the results of imaging examination of diabetes history and other related indicators, the related indicators of the two groups were compared. Multivariate logistic regression was used to analyze the influencing factors of stroke, the regression coefficient of relevant factors was used to establish the early warning model of stroke risk, and the relevant parameters were assigned according to the regression coefficient. The clinical value of ABCD2 and the early warning model in the diagnosis of stroke were analyzed by the ROC curve.
Results: There were significant differences in SBP≥ 140mmHg and/or DBP ≥ 90mmHg, limb and language disorders, diabetes history, duration, random blood glucose, RDW, and postural ataxia between the stroke group and the non-stroke group (P< 0.01). There was no significant difference in age> 60 years and sweating between the two groups (P> 0.05). In this study, the items with statistically significant differences between the two groups were included in the multivariate logistic regression analysis. The results showed that SBP ≥ 140mmHg and/or DBP ≥ 90mmHg, unilateral limb weakness, diabetes history, duration, RDW, and postural ataxia were the influencing factors of stroke (P<0.05 or <0.01). According to the multivariate logistic regression coefficient, the corresponding parameters were scored. According to the linear function, the regression coefficient of 0.9 was 1 point. The risk factors such as SBP ≥ 140mmHg and/or DBP ≥ 90mmHg, unilateral limb weakness, diabetes history, duration, RDW, and postural ataxia were assigned. ROC curve analysis showed that the AUC of ABCD2 in the diagnosis of stroke was 0.859, the sensitivity was 83.64%, the specificity was 86.94%; the AUC of the early warning model in the diagnosis of stroke was 0.915, the sensitivity was 94.58%, and the specificity was 92.74%.
Conclusion: Hypertension, duration of dizziness, postural ataxia, RDW, diabetes history, and unilateral limb weakness are the high-risk factors for vertigo patients with stroke in the emergency department. The early warning model established according to the above risk factors has good diagnostic value in the diagnosis of stroke patients and has the advantages of convenient and rapid application, which can be used in a clinical emergency. It is widely used in clinical diagnosis.
Emergency department, Stroke vertigo, High-risk factors, Early warning model, Clinical diagnostic value.