LO96: Syncope prognosis based on emergency department diagnosis: a prospective cohort study
| Autor: | K. Arcot, S. Kim, S. Gaudet, Cristian Toarta, M. Sivilotti, B.H. Rowe, M.A. Mukarram, V. Thiruganasambandamoorthy |
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| Rok vydání: | 2017 |
| Předmět: |
medicine.medical_specialty
Heart disease business.industry 030208 emergency & critical care medicine Emergency department medicine.disease Pulmonary embolism 03 medical and health sciences Orthostatic vital signs 0302 clinical medicine Internal medicine Emergency medicine Emergency Medicine medicine Etiology 030212 general & internal medicine Myocardial infarction Prospective cohort study business Vasovagal syncope |
| Zdroj: | CJEM. 19:S61 |
| ISSN: | 1481-8043 1481-8035 |
| DOI: | 10.1017/cem.2017.158 |
| Popis: | Introduction: Relatively little is known about outcomes after disposition among syncope patients assigned various diagnostic categories during emergency department (ED) evaluation. We sought to measure the 30-day serious outcomes among 4 diagnostic groups (vasovagal, orthostatic hypotension, cardiac, other/unknown) within 30 days of the index ED visit. Methods: We prospectively enrolled adult syncope patients at six EDs and excluded patients with pre-syncope, persistent mental status changes, intoxication, seizure, and major trauma. Patient characteristics, ED management, diagnostic impression (vasovagal, orthostatic, cardiac, or other/unknown) at the end of the ED visit and physicians’ confidence in assigning the etiology were collected. Serious outcomes at 30-days included: death, arrhythmia, myocardial infarction, structural heart disease, pulmonary embolism, and hemorrhage. Results: 5,010 patients (mean age 53.4 years; 54.8% females) were enrolled; 3.5% suffered serious outcomes: deaths (0.3%), arrhythmias (1.8%), non-arrhythmic cardiac (0.5%) and non-cardiac (0.9%). The cause of syncope was determined as vasovagal among 53.3% and cardiac in 5.4% of patients. The proportion of patients with ED investigations (pConclusion: Short-term serious outcomes strongly correlated with the etiology assigned in the ED visit. The physician’s clinical judgment should be incorporated in risk-stratification for prognostication and safe management of ED syncope patients. |
| Databáze: | OpenAIRE |
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