Predictors of 30-day serious events in older patients with syncope
| Autor: | Sun, BC, Derose, SF, Liang, LJ, Gabayan, GZ, Hoffman, JR, Moore, AA, Mower, WR, Mangione, CM |
|---|---|
| Rok vydání: | 2009 |
| Předmět: |
Male
Aging Clinical Sciences Middle Aged Prognosis Risk Assessment Emergency Care Emergency & Critical Care Medicine Syncope California Logistic Models Cardiovascular Diseases Risk Factors Clinical Research Multivariate Analysis 80 and over Humans Health Status Indicators Female Retrospective Studies Aged |
| Zdroj: | Annals of emergency medicine, vol 54, iss 6 Sun, BC; Derose, SF; Liang, LJ; Gabayan, GZ; Hoffman, JR; Moore, AA; et al.(2009). Predictors of 30-Day Serious Events in Older Patients With Syncope. Annals of Emergency Medicine, 54(6). doi: 10.1016/j.annemergmed.2009.07.027. UCLA: Retrieved from: http://www.escholarship.org/uc/item/6g09w43w |
| Popis: | Study objective: We identify predictors of 30-day serious events after syncope in older adults. Methods: We reviewed the medical records of older adults (age ≥60 years) who presented with syncope or near syncope to one of 3 emergency departments (EDs) between 2002 and 2005. Our primary outcome was occurrence of a predefined serious event within 30 days after ED evaluation. We used multivariable logistic regression to identify predictors of 30-day serious events. Results: Of 3,727 potentially eligible patients, 2,871 (77%) met all eligibility criteria. We excluded an additional 287 patients who received a diagnosis of a serious clinical condition while in the ED. In the final study cohort (n=2,584), we identified 173 (7%) patients who experienced a 30-day serious event. High-risk predictors included age greater than 90 years, male sex, history of an arrhythmia, triage systolic blood pressure greater than 160 mm Hg, abnormal ECG result, and abnormal troponin I level. A low-risk predictor was a complaint of near syncope rather than syncope. A risk score, generated by summing high-risk predictors and subtracting the low-risk predictor, can stratify patients into low- (event rate 2.5%; 95% confidence interval [CI] 1.4% to 3.6%), intermediate- (event rate 6.3%; 95% CI 5.1% to 7.5%), and high-risk (event rate 20%; 95% CI 15% to 25%) groups. Conclusion: We identified predictors of 30-day serious events after syncope in adults aged 60 years and greater. A simple score was able to stratify these patients into distinct risk groups and, if externally validated, might have the potential to aid ED decisionmaking. © 2009 American College of Emergency Physicians. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|