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Prospective cohort study on the predictors of fall risk in 119 patients with bilateral vestibulopathy
In: ISSN: 1932-6203 ; PLOS ONE, Vol. 15, No 3 (2020) P. e0228768 (2020)
Abstract: Objectives: To identify predictive factors for falls in patients with bilateral vestibulopathy (BV). Specific variables contributing to the general work-up of a vestibular patient were compared between BV patients experiencing falls and those who did not. Design: Prospective multi-centric cohort study. Setting: Department of Otorhinolaryngology & Head and Neck Surgery at two tertiary referral centers: Antwerp University Hospital and Maastricht University Medical Center. Participants: In total, 119 BV patients were included. BV diagnosis was defined in accordance with the diagnostic BV criteria, established by the Bárány Society in 2017. Main outcome measures: Patients were divided into fallers and non-fallers, depending on the experience of one or more falls in the preceding 12 months. Residual vestibular function on caloric testing, rotatory chair testing, video head impulse test (vHIT) and cervical vestibular evoked myogenic potentials (cVEMP) was evaluated as a predictive factor for falls. Furthermore, hearing function (speech perception in noise (SPIN)), sound localization performance, etiology, disease duration, sport practice, scores on the Dizziness Handicap Inventory (DHI) and the Oscillopsia Severity Questionnaire (OSQ) were compared between fallers and non-fallers. Results: Forty-five (39%) patients reported falls. In a sub-analysis in the patients recruited at UZA (n = 69), 20% experienced three or more falls and three patients (4%) suffered from severe fall-related injuries. The DHI score and the OSQ score were significantly higher in fallers. Residual vestibular function, SPIN, sound localization performance, etiology, disease duration, age and sport practice did not differ between fallers and non-fallers. Conclusions: Falls and (severe) fall-related injuries are frequent among BV patients. A DHI score > 47 and an OSQ score > 27.5 might be indicative for BV patients at risk for falls, with a sensitivity of 70% and specificity of 60%. Residual vestibular function captured by single vestibular tests (vHIT, calorics, rotatory chair, cVEMP) or by overall vestibular function defined as the number of impaired vestibular sensors are not suitable to distinguish fallers and non-fallers in a BV population.
Keyword: 80 and over; Accidental Falls / statistics & numerical data; Adult; Aged; Audiometry; Bilateral Vestibulopathy / complications; Bilateral Vestibulopathy / diagnosis; Bilateral Vestibulopathy / physiopathology; Caloric Tests / methods; Cohort Studies; Female; Head Impulse Test; Humans; info:eu-repo/classification/ddc/616.8; Male; Middle Aged; Postural Balance; Prospective Studies; Risk Assessment; Sensitivity and Specificity; Speech / methods; Surveys and Questionnaires; Tertiary Care Centers; Vestibular Evoked Myogenic Potentials; Young Adult
URL: https://archive-ouverte.unige.ch/unige:137148
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2
The Video Head Impulse Test
In: ETSU Faculty Works (2018)
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3
Vestibular Consequences of Noise Exposure in Humans
In: ETSU Faculty Works (2018)
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4
The Video Head Impulse Test: Background and Clinical Application
In: ETSU Faculty Works (2017)
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5
Reliability and Validity of Bertec Computerized Dynamic Posturography
In: ETSU Faculty Works (2017)
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6
Novel Video Head Impulse Findings in an Asymptomatic Individual with Unilateral Vestibular Loss
In: ETSU Faculty Works (2016)
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7
Reliability of Regression Gain Versus Instantaneous Gain During Video Head Impulse Testing
In: ETSU Faculty Works (2016)
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8
Intra- and Inter-Examiner Reliability of the Binocular Video Head Impulse Test
In: ETSU Faculty Works (2016)
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9
Intra- and Inter-Examiner Reliability of the Video Head Impulse Test
In: ETSU Faculty Works (2015)
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10
Inter-ocular Gain Differences of The Horizontal Vestibulo-ocular Reflex During the Video Head Impulse Test
In: ETSU Faculty Works (2015)
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11
Patterns of Vestibular Findings Among Veterans Presenting with Dizziness to the Vestibular Clinic
In: ETSU Faculty Works (2014)
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12
The Video Head Impulse Test: Normal Reference Intervals & Test-Retest Reliability
In: ETSU Faculty Works (2014)
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13
Intra- and Inter-Examiner Reliability of the Video Head Impulse Test
In: ETSU Faculty Works (2014)
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14
The Video Head Impulse Test
In: ETSU Faculty Works (2013)
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15
The Video Head Impulse Test
In: ETSU Faculty Works (2013)
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16
Vestibular-Related Traumatic Brain Injury: A Preliminary Voxel-Based Morphometry Analysis
In: ETSU Faculty Works (2013)
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17
Update on the Clinical Utility of Vestibular Evoked Myogenic Potentials
In: ETSU Faculty Works (2013)
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18
The Video Head Impulse Test
In: ETSU Faculty Works (2012)
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19
The Ocular Vestibular Evoked Myogenic Potential
In: ETSU Faculty Works (2011)
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20
Bone Conduction Ocular Vestibular Evoked Myogenic Potentials
In: ETSU Faculty Works (2011)
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