Vertigo Clinic Patients: A 2-Year Clinical Audit

Introduction Clinical audit “quality improvement process that seeks to improve patient care and outcomes through systematic review of care against explicit criteria and the implementation of change.”

Aims and Objectives:

1. Database of patient demographics serves as referral base.

2. Diagnoses to better focus on investigative tools.

3. Treatment benefits to modify our treatment protocols.

4. Academic study planning.

Materials and Methods Audit of vertigo clinic was conducted at Sri Ramachandra Medical College and Research Institute, Chennai, India. Data comprised 231 patients from Vertigo clinic between November 2015 and October 2017. Clinic conducted a complete and comprehensive evaluation of patients. Various tests conducted as a part of this evaluation were pure tone audiometry (PTA), vestibular evoked myogenic potentials (VEMP), X-ray cervical spine, carotid and vertebral Doppler, and MRI brain. Routine blood investigations, lipid and thyroid profiles are also done as indicated.

Results and Conclusion

Demographics Sex distribution was female predominant, 140 females and 91 males.

Diagnosis Most common diagnosis was benign paroxysmal positional vertigo (BPPV) with 145 patients, systemic causes, such as postural hypotension and cardiogenic etiology, were seen in 36 patients, Meniere's disease and vestibular migraine showed similar incidence with approximately 15 patients each. Less common conditions included vestibular neurolabyrinthitis, cervicogenic, psychogenic, and central and dynamic visual vertigo.

Treatment Protocol based, systematic treatment, and referrals were followed for all the patients.

Academic Auditing opened the scope for research activity in vestibular migraine, head impulse test and helped with fine tuning of the evaluation proforma and treatment protocols.