Risk Factors Associated With the Occurrence and Recurrence of Benign Paroxysmal Positional Vertigo in Koreans: A Nested Case-Control Study

Abstract

Objectives Benign paroxysmal positional vertigo (BPPV) is the most prevalent cause of vertigo. This study aims to analyze the risk factors associated with the occurrence and recurrence of BPPV. Methods A database maintained by the Korean National Health Insurance Service was used to analyze 434,552 patients diagnosed with BPPV from 2011 to 2017. The propensity score matching technique was employed to pair each participant with a control patient who did not have BPPV, ensuring equivalence in age, sex, residential status, and socioeconomic status. BPPV recurrence was defined as a new episode occurring more than 90 days after the initial treatment. Logistic regression analysis was conducted to examine the incidence of BPPV, while Cox proportional hazards models were used to investigate the risk factors associated with its recurrence. Results BPPV was found to be 2.2 times more prevalent in women, particularly peaking between the ages of 50 and 59. The 5-year recurrence rate for BPPV stood at 39.8%, with a significant number of cases reoccurring within the first year. The incidence of BPPV was statistically significantly linked to several underlying medical conditions, including vitamin D deficiency, thyroid hormone abnormalities, head trauma, and inner ear disorders. Notable risk factors for BPPV recurrence included advanced age, female sex, rural residence, low socioeconomic status, and the presence of inner ear diseases. Conclusion Our study provides significant insights into the risk factors linked to both the occurrence and recurrence of BPPV. Notably, there appears to be a connection with vitamin D levels, thyroid hormones, and estrogen. Additionally, conditions such as inner-ear disorders, head trauma, and otologic surgery were found to be strongly associated with both the initial onset and subsequent recurrence of BPPV.

Keywords

• benign paroxysmal positional vertigo
• vitamin d
• thyroid hormones
• nested case-control study