Development of a Clinical Risk Score to Risk Stratify for a Serious Cause of Vertigo in Patients Presenting to the Emergency Department

Development of a Clinical Risk Score to Risk Stratify for a Serious Cause of Vertigo in Patients Presenting to the Emergency Department

Robert Ohle, David W. Savage, Danielle Roy, Sarah McIsaac, Ravinder Singh, Daniel Lelli, Darren Tse, Peter Johns, Krishan Yadav, Jeffrey J. Perry
Annals of Emergency Medicine, June 2024
PMID: 39093245 | DOI: 10.1016/j.annemergmed.2024.06.003

✅ Conclusion:

The Sudbury Vertigo Risk Score is a promising clinical tool to identify patients with dizziness or vertigo who may have a serious underlying diagnosis. It demonstrates high sensitivity and may guide imaging, consultation, and disposition decisions. Validation in external cohorts is warranted.

📊 Methods:

• Design: Prospective cohort study over 3 years
  
  

• Setting: 3 university-affiliated tertiary care emergency departments
  
  

• Participants: 2,078 patients with vertigo, dizziness, or imbalance
  
  

• Outcome: Adjudicated diagnosis of serious central cause of vertigo
  
  

🧮 Sudbury Vertigo Risk Score Components:

1. Male sex
   
   

2. Age >65
   
   

3. Hypertension
   
   

4. Diabetes
   
   

5. Motor or sensory deficit
   
   

6. Cerebellar signs or symptoms
   
   

7. Negative BPPV diagnosis (absence = higher risk)
   
   

• Scoring and Risk Stratification:
  
  

• 
  
  

• Performance Metrics:
  
  

• Sensitivity: 100% (95% CI: 97.1–100%) for score <5
  
  

• Specificity: 72.1% (95% CI: 70.1–74%)
  
  

• C-statistic: 0.96 (95% CI: 0.92–0.98)
  
  

Ohle, R., Savage, D.W., Roy, D., McIsaac, S., Singh, R., Lelli, D., Tse, D., Johns, P., Yadav, K. and Perry, J.J., 2025. Development of a Clinical Risk Score to Risk Stratify for a Serious Cause of Vertigo in Patients Presenting to the Emergency Department. Annals of Emergency Medicine, 85(2), pp.122-131.