Kaohsiung Chang Gung Memorial Hospital, Taiwan
Posters & Accepted Abstracts: J Neurol Neurophysiol
Objectives & Aim: Vertigo/dizziness is some of the commonest reasons where adults seek medical advice during
emergency department (ED) visits. It is a challenge for emergency physicians (EPs) to identify few patients with
dizziness/vertigo caused by life threatening central nervous system (CNS) disorders among the overwhelming
majority of patients with benign dizziness/vertigo. This study aimed to evaluate the association between physician
seniority and head computed tomography (CT) use and ED length of stay (LOS) in ED patients with isolated
Methods: This retrospective cohort study included adult patients with non-traumatic isolated dizziness/vertigo examined in the ED. The EPs were categorized into three groups based on seniority: junior (â?¤6 years of work experience), intermediate (7â??12 years), and senior (â?¥12 years) groups.
Results: Of the 2291 patients with isolated dizziness/vertigo, 421(18.4%) received brain CTs; 44(1.9%) patients received a final diagnosis of CNS disorder. Compared with senior EPs, junior and intermediate EPs were more likely to order CT examinations [odds ratio (OR) =1.355, 95% confidence interval (CI): 1.007â??1.829 and OR=1.577, 95% CI: 1.197â??2.092]. Conversely, shorter ED LOS were noted for patients treated by junior and intermediate EPs (OR=- 0.280, 95% CI: -0.771â??0.211 and OR=-0.478, 95% CI: -0936 to -0.019).
Conclusions: This study identified different decision-making strategies among senior, intermediate, and junior EPs. Senior EPs had the lowest rate of CT use for patients with isolated vertigo/dizziness and was accompanied by a slightly longer LOS.
Ming-Ta Tsai has completed his Graduation from China Medical University College of Medicine in 2010. He is an attending physician in Department of Emergency Medicine, Kaohsiung Chang Gung Memorial Hospital, since 2016.