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Evaluation of consequential risk in ED patients with non-cardiac syncope.
Numeroso, Filippo; Naldoni, Teodora; Gnerre, Fabio; Sellaro, Cristian; Casagranda, Ivo.
Afiliación
  • Numeroso F; Emergency Department, University Hospital of Parma, 43121 Parma, Italy. Electronic address: fnumeroso@gmail.com.
  • Naldoni T; Postgraduate School of Emergency Medicine, University of Parma, 43121 Parma, Italy.
  • Gnerre F; Postgraduate School of Emergency Medicine, University of Parma, 43121 Parma, Italy.
  • Sellaro C; Postgraduate School of Emergency Medicine, University of Parma, 43121 Parma, Italy.
  • Casagranda I; Academy of Emergency Medicine and Care (AcEMC), 27100 Pavia, Italy.
Am J Emerg Med ; 84: 105-110, 2024 Oct.
Article en En | MEDLINE | ID: mdl-39106737
ABSTRACT

BACKGROUND:

Following standard syncope care, after exclusion of cardiac syncope, further workup is generally only recommended in cases of severe syncope due to consequential risk such that syncope is associated with injury or negative impacts on quality of life. This study is aimed to identify incidence and risk factors of severe syncope due to consequential risk, in a cohort of ED patients with non-cardiac syncope.

METHODS:

In a sample of 356 cases, we we conducted a case-control study comparing personal data, drug regimen, comorbidities, characteristics of syncope and previous episodes in patients with vs. without a severe syncope.

RESULTS:

Patients with severe syncope (120, 31.7% of total) resulted more frequently treated with a polypharmacy and CNS agents and affected by comorbidities entailing risk of falling; they more frequently had syncope occurred in a risky context, unwitnessed (55.8%), not preceded by prodromes (56.6%) and with clinical characteristics different from reflex syncope (82.3%); in these patients, previous episodes more frequently were clustered in the last years and complicated by major injuries. Absence of witnesses and prodromes and ED diagnosis different from reflex syncope resulted to be independently associated with severe syncope due to consequential risk.

CONCLUSIONS:

Syncope has a negative impact on a patient's life, through injuries or other personal consequences, in roughly one third of cases; to identity these patients, needing further investigation, emergency physicians should focus on episodes not preceded by prodromes, unwitnessed and with characteristic other than reflex syncope. Nonetheless, specific tools are needed to evaluate the impact of syncope on quality of life, to avoid clogging the path after ED discharge.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Síncope / Servicio de Urgencia en Hospital Límite: Adult / Aged / Aged80 / Female / Humans / Male / Middle aged Idioma: En Revista: Am J Emerg Med Año: 2024 Tipo del documento: Article Pais de publicación: Estados Unidos
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Síncope / Servicio de Urgencia en Hospital Límite: Adult / Aged / Aged80 / Female / Humans / Male / Middle aged Idioma: En Revista: Am J Emerg Med Año: 2024 Tipo del documento: Article Pais de publicación: Estados Unidos