Prospective evaluation and outcome of patients admitted for syncope over a 1 year period

Blanc, Jean‐Jacques; L'Her, C.; Touiza, A.; Garo, B.; L’Her, Erwan; Mansourati, Jacques

doi:10.1053/euhj.2001.2975

Cited by 270 publications

(159 citation statements)

References 14 publications

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“…Recent studies from Europe report that 0.9 to 1.2 % of the visits to community-based emergency departments are due to syncope [3,9,17,42,51]. The remarkably consistent fraction of about 1 % in emergency departments in Europe is lower than the 3 % from an older study by Day et al that is often quoted for the frequency of syncope in emergency departments in the USA [11,15,20].…”

Section: ■ Syncope In Emergency Departmentsmentioning

confidence: 98%

Epidemiology of reflex syncope

Colman

Nahm

Ganzeboom³

et al. 2004

Clin Auton Res

235

159

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Section: ■ Syncope In Emergency Departmentsmentioning

confidence: 98%

Epidemiology of reflex syncope

Colman

Nahm

Ganzeboom³

et al. 2004

Clin Auton Res

235

159

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“…[1][2][3][4][5] It represents a common clinical problem, accounting for 1%-3% of visits to the emergency department and up to 6% of admissions to acute care hospitals. 6,7 Assessment of syncope in patients presenting to the emergency department is challenging because of the heterogeneity of underlying pathophysiologic processes and diseases. Although many underlying causes of syncope are benign, others are associated with substantial morbidity or mortality, including cardiac arrhythmia, myocardial infarction, pulmonary embolism and occult hemorrhage.…”

mentioning

confidence: 99%

San Francisco Syncope Rule to predict short-term serious outcomes: a systematic review

Saccilotto

Nickel²,

Bucher³

et al. 2011

CMAJ

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Background:The San Francisco Syncope Rule has been proposed as a clinical decision rule for risk stratification of patients presenting to the emergency department with syncope. It has been valid ated across various populations and settings. We undertook a systematic review of its accuracy in predicting short-term serious outcomes. Methods:We identified studies by means of systematic searches in seven electronic databases from inception to January 2011. We extracted study data in duplicate and used a bivariate random-effects model to assess the predictive accuracy and test characteristics. Results:We included 12 studies with a total of 5316 patients, of whom 596 (11%) experienced a serious outcome. The prevalence of serious outcomes across the studies varied between 5% and 26%. The pooled estimate of sensitivity of the San Francisco Syncope Rule was 0.87 (95% confidence interval [CI] 0.79-0.93), and the pooled estimate of specificity was 0.52 (95% CI 0.43-0.62). There was substantial between-study heterogeneity (resulting in a 95% prediction interval for sensitivity of 0.55-0.98). The probability of a serious outcome given a negative score with the San Francisco Syncope Rule was 5% or lower, and the probability was 2% or lower when the rule was applied only to patients for whom no cause of syncope was identified after initial evaluation in the emergency department. The most common cause of false-negative classification for a serious outcome was cardiac arrhythmia. Interpretation:The San Francisco Syncope Rule should be applied only for patients in whom no cause of syncope is evident after in itial evaluation in the emergency department. Consideration of all available electrocardiograms, as well as arrhythmia monitoring, should be included in application of the San Francisco Syncope Rule. Between-study hetero geneity was likely due to inconsistent classification of arrhythmia. AbstractSee related commentary by Parry at www.cmaj.ca/lookup

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“…It shows that syncope contributes for 0.71% of admissions on the medical ward and as expected, the number of patients admitted increases sharply after 60 years, as it was also remarked by Blanc et al [8]. And for this reason, it poses special consideration in light of multiple comorbid conditions, especially uncontrolled hypertension and history of heart failure [6].…”

Section: Discussionmentioning

confidence: 82%

The Etiology of Syncope in an Emergency Hospital

Bădilă

Negrea

Rîpă

et al. 2016

Romanian Journal of Internal Medicine

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Background. Syncope is a commonly encountered problem in an emergency hospital. Global cerebral hypoperfusion is the final pathway common to all presentations of syncope, but this symptom presentation has a broad differential diagnosis. It is important to identify patients for whom syncope is a symptom of a potentially life-threatening condition.Material and methods. We identified adult patients presenting with syncope to the Emergency Department of our hospital from January 2012 to June 2014. Of 590 patients found in the hospital database we further selected 217 patients who met our criteria, namely having a positive diagnosis of syncope (being clearly distinguished from other TLOCs) and an etiology of the disease. Thus, definite diagnosis was established retrospectively by reviewing medical records.Results. The demographics of our group shows a slightly different distribution between men and women (49% men and 51% women) and a majority of the urban population (67%). As for the age range, most of our patients were in the age group of 70-80 years (30%), 29% were > 80 years old, and the percentage decreases significantly in the 60-70 years range (17%). The most frequent causes of syncope were cardiac (32%), vasovagal (23%) and due to orthostatic hypotension (12%), but we have also found various cases of mixt or iatrogenic causes.Conclusions. The incidence of syncope increases sharply after 70 years of age and poses special consideration in light of multiple comorbid conditions, age-related changes, atypical presentation, and concomitant medication use. The most common causes of syncope in this population are cardiac causes, orthostatic hypotension and carotid sinus hypersensitivity. Often, root cause of syncope remains undiagnosed, despite exhaustive diagnostic testing.

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Prospective evaluation and outcome of patients admitted for syncope over a 1 year period

Abstract: Syncope is a frequent symptom but its cause often remains unknown partly due to inadequate management. Precise and simple guidelines are urgently needed.

Cited by 270 publications

References 14 publications

Epidemiology of reflex syncope

Epidemiology of reflex syncope

San Francisco Syncope Rule to predict short-term serious outcomes: a systematic review

The Etiology of Syncope in an Emergency Hospital

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