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Background <p>Acute peripheral vertigo often demands rapid treatment and specialty input in the emergency department (ED). We examined how real‑world treatment patterns relate to ED length of stay (LOS).</p> Methods <p>We performed a cross‑sectional review of adults with peripheral vertigo at Rasool‑e‑Akram Hospital (Tehran, Jan–Jun 2024). After prespecified exclusions, 96 encounters remained. Vertigo‑specific drugs (ondansetron, betahistine, promethazine, metoclopramide, benzodiazepines), regimen complexity (≤ 2 vs. ≥ 3 drugs), and consultations were abstracted; LOS (minutes) was the outcome. Linear regression adjusted for age, sex, regimen complexity, consultations, and self‑discharge; secondary models estimated drug‑specific associations.</p> Results <p>Median LOS was longer with complex regimens than with simpler regimens (652 vs. 467.5&#xa0;min; <i>p</i> = 0.0016). In the adjusted model, regimen complexity ≥ 3 drugs was associated with a 180.9‑minute longer LOS (95% confidence interval (CI) 76.0–285.7; <i>p</i> = 0.0009). Neurology (β 163.9&#xa0;min), internal medicine (β 501.3&#xa0;min) and ENT (β 476.0&#xa0;min) consultations were likewise associated with longer stays (all <i>p</i> &lt; 0.01). Drug‑specific models showed benzodiazepines linked to longer LOS (β 356.2&#xa0;min; <i>p</i> &lt; 0.0001) and promethazine linked to shorter LOS (β − 161.3&#xa0;min; <i>p</i> = 0.015); other agents showed no clear independent association.</p> Conclusion <p>In this ED cohort, simpler pharmacotherapy and selective consultation were associated with shorter LOS, whereas complex regimens and certain consultations tracked with longer stays. These findings are hypothesis‑generating and support evaluating stepwise treatment pathways in prospective studies.</p>

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Therapeutic approaches and their association with hospitalization duration in patients with peripheral vertigo presenting to the emergency department

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年2月3日

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  • Seyedamir Tabibzadeh Dezfooli,
  • Alireza Rahbar Nikoukar,
  • Reza Mosaddegh,
  • Mahdi Rezai,
  • Nava Soleymani,
  • Alireza Javan,
  • Danyal Yarahmadi,
  • Ali Rahnamaei

摘要

Background

Acute peripheral vertigo often demands rapid treatment and specialty input in the emergency department (ED). We examined how real‑world treatment patterns relate to ED length of stay (LOS).

Methods

We performed a cross‑sectional review of adults with peripheral vertigo at Rasool‑e‑Akram Hospital (Tehran, Jan–Jun 2024). After prespecified exclusions, 96 encounters remained. Vertigo‑specific drugs (ondansetron, betahistine, promethazine, metoclopramide, benzodiazepines), regimen complexity (≤ 2 vs. ≥ 3 drugs), and consultations were abstracted; LOS (minutes) was the outcome. Linear regression adjusted for age, sex, regimen complexity, consultations, and self‑discharge; secondary models estimated drug‑specific associations.

Results

Median LOS was longer with complex regimens than with simpler regimens (652 vs. 467.5 min; p = 0.0016). In the adjusted model, regimen complexity ≥ 3 drugs was associated with a 180.9‑minute longer LOS (95% confidence interval (CI) 76.0–285.7; p = 0.0009). Neurology (β 163.9 min), internal medicine (β 501.3 min) and ENT (β 476.0 min) consultations were likewise associated with longer stays (all p < 0.01). Drug‑specific models showed benzodiazepines linked to longer LOS (β 356.2 min; p < 0.0001) and promethazine linked to shorter LOS (β − 161.3 min; p = 0.015); other agents showed no clear independent association.

Conclusion

In this ED cohort, simpler pharmacotherapy and selective consultation were associated with shorter LOS, whereas complex regimens and certain consultations tracked with longer stays. These findings are hypothesis‑generating and support evaluating stepwise treatment pathways in prospective studies.