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rdf:type |
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lifeskim:mentions |
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pubmed:issue |
3
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pubmed:dateCreated |
2007-11-2
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pubmed:abstractText |
Syncope is a common presentation to the Emergency Department (ED); however, appropriate management and indications for hospitalization remain an ongoing challenge. The objective of this study was to determine if a predefined decision rule could accurately identify patients with syncope likely to have an adverse outcome or critical intervention. A prospective, observational, cohort study was conducted of consecutive ED patients aged 18 years or older presenting with syncope. A clinical decision rule was developed a priori to identify patients at risk if they met any of the following 8 criteria: 1) Signs and symptoms of acute coronary syndrome; 2) Signs of conduction disease; 3) Worrisome cardiac history; 4) Valvular heart disease by history or physical examination; 5) Family history of sudden death; 6) Persistent abnormal vital signs in the ED; 7) Volume depletion; 8) Primary central nervous system event. The primary outcome was either a critical intervention or an adverse outcome within 30 days. Among 362 patients enrolled with syncope, 293 (81%) patients completed their 30-day follow-up. Of these, 201 (69%) were admitted. There were 68 patients (23%) who had either a critical intervention or adverse outcome. The rule identified 66/68 patients who met the outcome for a sensitivity of 97% (95% confidence interval 93-100%) and specificity of 62% (56-69%). This pathway may be useful in identifying patients with syncope who are likely to have adverse outcome or critical interventions. Implementation and multicenter validation is needed before widespread application.
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pubmed:grant |
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pubmed:commentsCorrections |
http://linkedlifedata.com/resource/pubmed/commentcorrection/17976548-10350668,
http://linkedlifedata.com/resource/pubmed/commentcorrection/17976548-10527021,
http://linkedlifedata.com/resource/pubmed/commentcorrection/17976548-10629914,
http://linkedlifedata.com/resource/pubmed/commentcorrection/17976548-11385356,
http://linkedlifedata.com/resource/pubmed/commentcorrection/17976548-11843472,
http://linkedlifedata.com/resource/pubmed/commentcorrection/17976548-1404823,
http://linkedlifedata.com/resource/pubmed/commentcorrection/17976548-14747812,
http://linkedlifedata.com/resource/pubmed/commentcorrection/17976548-15721118,
http://linkedlifedata.com/resource/pubmed/commentcorrection/17976548-15894963,
http://linkedlifedata.com/resource/pubmed/commentcorrection/17976548-16631985,
http://linkedlifedata.com/resource/pubmed/commentcorrection/17976548-2189056,
http://linkedlifedata.com/resource/pubmed/commentcorrection/17976548-2666973,
http://linkedlifedata.com/resource/pubmed/commentcorrection/17976548-3136095,
http://linkedlifedata.com/resource/pubmed/commentcorrection/17976548-6344721,
http://linkedlifedata.com/resource/pubmed/commentcorrection/17976548-6866032,
http://linkedlifedata.com/resource/pubmed/commentcorrection/17976548-7091170,
http://linkedlifedata.com/resource/pubmed/commentcorrection/17976548-7588197,
http://linkedlifedata.com/resource/pubmed/commentcorrection/17976548-8678086,
http://linkedlifedata.com/resource/pubmed/commentcorrection/17976548-9095005,
http://linkedlifedata.com/resource/pubmed/commentcorrection/17976548-9095018,
http://linkedlifedata.com/resource/pubmed/commentcorrection/17976548-9348043
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pubmed:language |
eng
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pubmed:journal |
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pubmed:citationSubset |
IM
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pubmed:status |
MEDLINE
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pubmed:month |
Oct
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pubmed:issn |
0736-4679
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pubmed:author |
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pubmed:issnType |
Print
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pubmed:volume |
33
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pubmed:owner |
NLM
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pubmed:authorsComplete |
Y
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pubmed:pagination |
233-9
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pubmed:dateRevised |
2011-1-12
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pubmed:meshHeading |
pubmed-meshheading:17976548-Adult,
pubmed-meshheading:17976548-Aged,
pubmed-meshheading:17976548-Algorithms,
pubmed-meshheading:17976548-Clinical Protocols,
pubmed-meshheading:17976548-Comorbidity,
pubmed-meshheading:17976548-Decision Support Techniques,
pubmed-meshheading:17976548-Emergency Medicine,
pubmed-meshheading:17976548-Emergency Service, Hospital,
pubmed-meshheading:17976548-Female,
pubmed-meshheading:17976548-Humans,
pubmed-meshheading:17976548-Male,
pubmed-meshheading:17976548-Middle Aged,
pubmed-meshheading:17976548-Prospective Studies,
pubmed-meshheading:17976548-Risk Assessment,
pubmed-meshheading:17976548-Sensitivity and Specificity,
pubmed-meshheading:17976548-Syncope
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pubmed:year |
2007
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pubmed:articleTitle |
Predicting adverse outcomes in syncope.
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pubmed:affiliation |
Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts 02115, USA.
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pubmed:publicationType |
Journal Article
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