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Purpose <p>To explore the multidimensional factors associated with the recovery trajectory in patients with persistent residual dizziness (RD) following successful repositioning for benign paroxysmal positional vertigo (BPPV), thereby providing evidence for clinical assessment and intervention.</p> Methods <p>We retrospectively enrolled 169 patients with BPPV and persistent RD following successful repositioning. The primary outcome was the recovery trajectory of RD, defined as an ordinal categorical variable based on follow-up assessments at Day 7 and Day 14. Univariate analysis and ordered logistic regression models were used to assess prognostic factors.</p> Results <p>Univariate analysis identified age, pretreatment dizziness duration ≥ 7 days, Canalith Repositioning Procedure (CRP) ≥ 2 sessions, history of BPPV recurrence, hypertension, hyperlipidemia, diabetes mellitus, Dizziness Handicap Inventory score, Anxiety Sensitivity Index-3 (ASI-3) score, and Pittsburgh Sleep Quality Index (PSQI) score as potential risk factors (<i>P</i> &lt; 0.05). Multivariate analysis identified six independent risk factors: age (odds ratio [OR] = 1.06, 95% confidence interval [CI] 1.02–1.10, <i>P</i> = 0.006), pre-treatment vertigo duration ≥ 7 days (OR = 6.35, 95% CI 2.84–14.20, <i>P</i> &lt; 0.001), history of BPPV recurrence (OR = 3.01, 95% CI 1.17–7.77, <i>P</i> = 0.023), history of diabetes mellitus (OR = 4.58, 95% CI 1.26–16.65, <i>P</i> = 0.021), ASI-3 score (OR = 1.04, 95% CI 1.01–1.08, <i>P</i> = 0.014), and PSQI score (OR = 1.40, 95% CI 1.23–1.58, <i>P</i> &lt; 0.001).</p> Conclusion <p>RD prognosis is influenced by multidimensional factors. Independent risk factors include pretreatment vertigo duration ≥ 7 days (the strongest independent risk, OR = 6.35), advanced age, history of BPPV recurrence, diabetes, anxiety sensitivity, and sleep quality. Vertigo severity was not significantly associated with RD recovery trajectory. Therefore, clinical management of RD should extend beyond short-term symptom control. Effective risk prevention and management require early identification and targeted intervention to address risk factors.</p>

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Multidimensional factors influencing the recovery trajectory of residual dizziness after successful canalith repositioning in benign paroxysmal positional vertigo: an ordered logistic regression analysis

  • 期刊论文

  • 发表日期：

    2026年7月5日

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  • Mingqiang Yu,
  • Chenyang Lei,
  • Ting Zou,
  • Jun Su,
  • Hongyi Lu

摘要

Purpose

To explore the multidimensional factors associated with the recovery trajectory in patients with persistent residual dizziness (RD) following successful repositioning for benign paroxysmal positional vertigo (BPPV), thereby providing evidence for clinical assessment and intervention.

Methods

We retrospectively enrolled 169 patients with BPPV and persistent RD following successful repositioning. The primary outcome was the recovery trajectory of RD, defined as an ordinal categorical variable based on follow-up assessments at Day 7 and Day 14. Univariate analysis and ordered logistic regression models were used to assess prognostic factors.

Results

Univariate analysis identified age, pretreatment dizziness duration ≥ 7 days, Canalith Repositioning Procedure (CRP) ≥ 2 sessions, history of BPPV recurrence, hypertension, hyperlipidemia, diabetes mellitus, Dizziness Handicap Inventory score, Anxiety Sensitivity Index-3 (ASI-3) score, and Pittsburgh Sleep Quality Index (PSQI) score as potential risk factors (P < 0.05). Multivariate analysis identified six independent risk factors: age (odds ratio [OR] = 1.06, 95% confidence interval [CI] 1.02–1.10, P = 0.006), pre-treatment vertigo duration ≥ 7 days (OR = 6.35, 95% CI 2.84–14.20, P < 0.001), history of BPPV recurrence (OR = 3.01, 95% CI 1.17–7.77, P = 0.023), history of diabetes mellitus (OR = 4.58, 95% CI 1.26–16.65, P = 0.021), ASI-3 score (OR = 1.04, 95% CI 1.01–1.08, P = 0.014), and PSQI score (OR = 1.40, 95% CI 1.23–1.58, P < 0.001).

Conclusion

RD prognosis is influenced by multidimensional factors. Independent risk factors include pretreatment vertigo duration ≥ 7 days (the strongest independent risk, OR = 6.35), advanced age, history of BPPV recurrence, diabetes, anxiety sensitivity, and sleep quality. Vertigo severity was not significantly associated with RD recovery trajectory. Therefore, clinical management of RD should extend beyond short-term symptom control. Effective risk prevention and management require early identification and targeted intervention to address risk factors.