Citation

Liao WL, Chang TP, Chen HJ, Kao CH. J. Orthop. Sports Phys. Ther. 2015; 45(5): 406-412.

Affiliation

Department of Physical Medicine and Rehabilitation, Taichung Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Taichung, Taiwan.

Copyright

(Copyright © 2015, Orthopaedic Section and Sports Physical Therapy Section of the American Physical Therapy Association)

DOI

10.2519/jospt.2015.5707

PMID

25808526

Abstract

Study Design A nationwide population-based retrospective cohort study.

OBJECTIVEs To investigate whether benign paroxysmal positional vertigo (BPPV) is associated with an increased risk of fracture. Background BPPV is a brief rotational vertigo induced by head position change that may increase the risk of falls and therefore fracture.

METHODS Data from the Taiwan National Health Insurance Research database were used for this study. We established a case cohort comprising 3796 patients aged over 20 years who were newly diagnosed with BPPV between 2000 and 2006. In addition, we formed a control cohort by randomly selecting 15 184 people without BPPV. Matching patients with BPPV to controls according to sex, age, and index year, Cox proportional hazard regressions were performed to compute the hazard ratio (HR) of fracture after we adjusted for demographic characteristics and comorbidities.

RESULTS The prevalence of comorbidities was higher among patients with BPPV. After adjusting for age, sex, and comorbidities, patients with BPPV exhibited a 1.14-fold (95% confidence interval [CI] 1.04, 1.25; P<.01) higher risk of fracture than those without BPPV. Trunk fracture (vertebra, rib, and pelvis) was the fracture type with the highest adjusted HR (1.24, 95% CI 1.06, 1.45, P<.01) in patients with BPPV relative to those without BPPV. An analysis stratified according to demographic factors revealed that men with BPPV exhibited a 1.43-fold (95% CI 1.22, 1.66; P <.001) higher risk of fracture. Patients with BPPV aged over 65 years exhibited a significantly higher risk of fracture (adjusted HR: 1.17; 95% CI 1.03, 1.33; P <.05) than did those without BPPV.

CONCLUSION Patients with BPPV exhibited a higher risk of fracture than did those without BPPV. Level of Evidence Prognosis, Level 2b. J Orthop Sports Phys Ther, Epub 26 Mar 2015. doi:10.2519/jospt.2015.5707.

Language: en