Outcomes of Patients With Syncope and Suspected Dementia

Abstract

Patients with perceived dementia who presented to the ED with syncope or near-syncope were frequently hospitalized. The diagnosis of a serious condition was uncommon if not identified during the initial ED assessment. Given the known iatrogenic risks of hospitalization for patients with dementia, future investigation of the impact of goals of care discussions on reducing potentially preventable, futile, or unwanted hospitalizations while improving goal-concordant care is warranted.

Clinical characteristics of patients with dementia in a local emergency clinic in Japan

“…2) might be because of their low short-term risk of adverse outcomes. 20 In conclusion, patients with dementia are common in our emergency clinic. These patients are older in age, have a higher hospitalization rate and spend a longer time in hospital, especially due to stroke and falls, than patients without dementia.…”

“…Our finding of shorter hospital stays for patients with dementia who were admitted for syncope and loss of consciousness (Fig. ) might be because of their low short‐term risk of adverse outcomes …”

Optimal Emergency Department Care Practices for Persons Living With Dementia: A Scoping Review

“…Studies on emergency care needs for PLWDs included BPSDs, 48,57,62,65 functional ability, 47,51,54,61 pain, 49,51,62,63 difficulties with ED care, 52,53,59,60,68 and common complaints and diagnoses. 45,46,50,57,58,64,69 These studies suggest that special attention should be paid to BPSDs, functional ability, and pain as common needs leading to ED visits. Decreasing stimulation and improving communication between clinicians, PLWDs, and care partners in the ED would address some of the difficulties PLWDs have with ED care and should be addressed in future studies.…”

“…Two were abstracts only. 54,66 Most of the studies were qualitative (8), 49,52,53,59,60,63,66,67 followed by prospective cohort (7), 47,48,50,51,54,61,62 retrospective cohort (7), 8,46,56,58,64,65,69 literature review (3), 2,55,68 and survey (2). 45,57 Participants were recruited from 1999 to 2018.…”

“…Seven articles evaluated common reasons for ED use, and diagnoses made in PLWDs. 45,46,50,57,58,64,69 Common reasons for ED visits were pain; falls or injury; altered mental status; fluid or electrolyte imbalance; infection; immobility; medication side effects; respiratory, digestive, or cardiovascular issues; stroke; worsening dementia severity; and nonspecific symptoms. A study of Medicare claims data found that a diagnosis of urinary tract infection was recorded in more than 33% of all ED encounters for PLWDs, compared with 13.4% in older adults without dementia.…”