The application of STANDING bedside algorithm in differential diagnosis of acute vertigo

Objective To assess the diagnostic performance of STANDING (spontaneous nystagmus, direction, head impulse test, standing) bedside algorithm to differentiate central form non-central acute vertigo (AV). Methods The clinical data of adult patients presenting to the emergency department with vertigo were collected and evaluated with STANDING. The sensibility and specificity of STANDING in diagnosis of central vertigo were calculated. Results A total of 85 patients who were treated in Anhui Provincial Hospital from October, 2016 to May, 2017 and met the criteria were included. And 16 cases had a diagnosis of central AV, 60 cases had a diagnosis of peripheral AV, and 9 cases were unclear. The sensitivity of STANDING in diagnosis of central vertigo is 100%, and its specificity is 87%. All the patients were divided into stroke group (9 cases,10.6%) and non-stroke group (76 cases, 89.4%). The average ages of stroke group and non-stroke group are respectively (67.3±5.7) years of age and (56.2±16.2) years of age (t=2.028, P=0.046). All stroke group patients have more than one stroke risk factor, but only 24 (31.6%) cases of non-stroke group patients do the same, which showed statistical significance between the two groups (χ²=7.413, P=0.006). Conclusion STANDING bedside algorithm can preliminarily screen central AV with a very high sensitivity in Emergency room, and central AV with many stroke risk factors have a higher possibility of stroke.