TY - JOUR
T1 - Prospective cohort study on the predictors of fall risk in 119 patients with bilateral vestibulopathy
AU - Dobbels, Bieke
AU - Lucieer, Florence
AU - Mertens, Griet
AU - Gilles, Annick
AU - Moyaert, Julie
AU - van de Heyning, Paul
AU - Guinand, Nils
AU - Fornos, Angelica Perez
AU - Herssens, Nolan
AU - Hallemans, Ann
AU - Vereeck, Luc
AU - Vanderveken, Olivier
AU - Van Rompaey, Vincent
AU - van de Berg, Raymond
N1 - Funding Information:
The Antwerp University Hospital, Maastricht University Medical Center, and Geneva University Hospitals have received research and travel grants from MED-EL. The funder had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
Publisher Copyright:
© 2020 Dobbels et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
PY - 2020/3/9
Y1 - 2020/3/9
N2 - ObjectivesTo 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.DesignProspective multi-centric cohort study.SettingDepartment of Otorhinolaryngology & Head and Neck Surgery at two tertiary referral centers: Antwerp University Hospital and Maastricht University Medical Center.ParticipantsIn total, 119 BV patients were included. BV diagnosis was defined in accordance with the diagnostic BV criteria, established by the Barany Society in 2017.Main outcome measuresPatients 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.ResultsForty-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.ConclusionsFalls 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.
AB - ObjectivesTo 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.DesignProspective multi-centric cohort study.SettingDepartment of Otorhinolaryngology & Head and Neck Surgery at two tertiary referral centers: Antwerp University Hospital and Maastricht University Medical Center.ParticipantsIn total, 119 BV patients were included. BV diagnosis was defined in accordance with the diagnostic BV criteria, established by the Barany Society in 2017.Main outcome measuresPatients 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.ResultsForty-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.ConclusionsFalls 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.
KW - QUALITY-OF-LIFE
KW - MYOGENIC POTENTIALS
KW - HYPOFUNCTION
U2 - 10.1371/journal.pone.0228768
DO - 10.1371/journal.pone.0228768
M3 - Article
C2 - 32150553
SN - 1932-6203
VL - 15
JO - PLOS ONE
JF - PLOS ONE
IS - 3
M1 - 0228768
ER -