Balance disorders as potential confounders associated with an increased risk of acute cerebrovascular accidents
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OTOLOGY
Balance disorders as potential confounders associated with an increased risk of acute cerebrovascular accidents Emilio Domínguez‑Durán1 · Irene Mármol‑Szombathy1,2 · María José López‑Urbano3 · Ana Palomo‑Sánchez3 · Fátima Alarcón‑Balanza4 · Estela Palmero‑Olmo5 · Ana Nogales‑Nieves6 · Pablo Otero‑Aguilar7 · Blas Poyatos‑Poyatos6 · Manuel Torres‑Rodríguez8 · María Teresa Manjón‑Collado8 · Beatriz Bullón‑Fernández4 · Manuela Campos‑Holguín9 · Feliciana Valle‑Martín9 · Patricia Medina‑Moreno10 · Antonio Mora‑Quintero10 · Serafín Sánchez‑Gómez1 Received: 21 September 2020 / Accepted: 28 October 2020 © Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Purpose There is a higher risk of stroke after suffering from balance disorders (BDs) such as vertigo or dizziness. The causal relationship remains unclear due to the limited scope of the existing studies and the high prevalence of cardiovascular risk factors (CVRFs) in BD patients. The objective of this study is to clarify the role that BDs seem to have in the development of acute cerebrovascular accidents (ACAs). Methods This is an observational prospective study. The CVRFs and demographic factors of a sample of our population were noted. Five clusters of patients were tracked over the course of 2 years to detect and diagnose BDs and ACAs. The causal relationships between the CVRFs, BDs and ACAs were analyzed in a univariate analysis. A logistic regression multivariant analysis was performed on those variables that reached statistical significance. Results The sample included 7886 participants and 31 ACAs were recorded. CVRFs that reached statistical significance included age ≥ 60, hypertension, diabetes mellitus, dyslipidemia, ischemic heart disease, atrial fibrillation and previous ACAs. The relationship between BDs and ACAs always reached statistical significance, regardless of how the BD variable was defined. Five different multivariate analyses were performed, but in none of them did the BD variables significantly reduce the deviance and thus, they were not taken into account when building the final model. Conclusion This study shows that BDs are probably confounders that are closely linked to other CVRFs and they are also useful red flags to identify patients at a higher risk of suffering from ACAs. Keywords Vertigo · Dizziness · Stroke · Risk factors
* Emilio Domínguez‑Durán [email protected] 1
Unidad de Gestión Sanitaria de Otorrinolaringología, Hospital Universitario Virgen Macarena, Avenida Doctor Fedriani 3, 41009 Sevilla, Spain
2
Servicio de Otorrinolaringología, Hospital Universitario Nuestra Señora de Valme, Sevilla, Spain
3
Distrito Sanitario de Atención Primaria de Sevilla, Sevilla, Spain
4
Centro de Salud “Pino Montano A”, Sevilla, Spain
5
Distrito Sanitario de Atención Primaria “Sevilla Norte”, Sevilla, Spain
6
Centro de Salud “Polígono Norte”,, Sevilla, Spain
7
Centro de Salud “Mercedes Navarro”, Sevilla, Spain
8
Centro de Salud “El Mirador” San José de la Rinc
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