The value of multidisciplinary team in syncope clinic for the effective diagnosis of complex syncope
| Autor: | Jing‐jiong Chen, Ye‐sheng Pan, Xiaolin Qian, Jingbo Li, Dong Huang, Qing‐qing Jiang |
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| Rok vydání: | 2018 |
| Předmět: |
Male
medicine.medical_specialty 030204 cardiovascular system & hematology Multidisciplinary team Syncope Hospitalization rate Diagnosis Differential 03 medical and health sciences Orthostatic vital signs 0302 clinical medicine Cardiologists Medicine Humans 030212 general & internal medicine Reflex syncope Neurologists Medical History Taking Physical Examination Patient Care Team biology business.industry Syncope (genus) Mean age General Medicine Emergency department Middle Aged biology.organism_classification Emergency medicine Etiology Female Cardiology and Cardiovascular Medicine business Emergency Service Hospital |
| Zdroj: | Pacing and clinical electrophysiology : PACE. 42(7) |
| ISSN: | 1540-8159 |
| Popis: | Background Syncope is a perplexing challenge that often receives thorough evaluation, yet the diagnosis remains unclear. Usually, the emergency department is the first point at which patients present with syncope. However, diverse medical factors, including low diagnostic rates and inconsistent management by doctors, add to healthcare costs and delay diagnosis for syncope patients. Methods Patients who had been to the emergency department at least once but were not given a clear diagnosis of syncope were recruited into our study at the time they visited syncope clinic staffed by a multidisciplinary team. Complete medical histories and clinical examinations were conducted by both experienced cardiologists and neurologists. If patients were not given a conclusive diagnosis at the syncope clinic on the basis of outpatient examinations, they were admitted for further evaluation. Results A total of 209 consecutive patients claiming "syncope" visited the syncope clinic, yet only 167 patients were formally diagnosed with syncope. For these 167 patients, the mean age was 55.93 ± 17.40 years old, and 41.3% were male. The proportions of cardiac syncope, reflex syncope, orthostatic hypotension (OH), and syncope of uncertain etiology were 19.8%, 64.1%, 7.8%, and 8.4%, respectively. The diagnostic rate was 91.6%, and the hospitalization rate was 23.4%. Patients with reflex syncope and OH were younger than patients with cardiac syncope. Cardiac syncope tends to occur more frequently in males, while reflex syncope is more likely in females. Conclusions The cooperation of professional cardiologists and neurologists will play an important role in improving diagnostic rates, lowering admission rates, and reducing medical costs. |
| Databáze: | OpenAIRE |
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