OBJECTIVES: To assess the relationship between age and 14-day serious events after an emergency department (ED) visit for syncope. DESIGN: One-year prospective cohort study. SETTING: Single academic ED. PARTICIPANTS: Adult patients with an ED complaint of syncope or near-syncope. MEASUREMENTS: Treating physicians prospectively recorded the presence or absence of potential risk factors for serious clinical events. Patients were contacted by telephone at 14 days for a structured interview. A three-physician panel reviewed ED charts, hospital records, and telephone interview forms to identify predefined events. The primary outcome included any 14-day predefined event. A secondary outcome included any 14-day predefined event that was first diagnosed after the initial ED visit. Age was analyzed in 20-year intervals. Multivariate logistic regression controlled for baseline demographic, comorbidity, and electrocardiogram data. RESULTS: Of 592 eligible patients, 477 (81%) provided informed consent. Follow-up was successfully obtained for 463 (97%) patients. The age range was 18 to 96, and 47% of patients were aged 60 and older. There were 80 (17%) patients who had a 14-day event, including 18 (4%) with a delayed diagnosis. Compared with patients aged 18 to 39, the adjusted odds ratio (OR) of a serious outcome was 2.7 (95% confidence interval (CI)=0.9-8.4) for patient aged 40 to 59, 3.8 (95% CI=1.3-12) for patients aged 60 to 79, and 3.8 (95% CI=1.2-12) for patients aged 80 and older. CONCLUSION: Age of 60 and older is strongly associated with short-term serious events after an ED visit for syncope.
OBJECTIVES: To assess the relationship between age and 14-day serious events after an emergency department (ED) visit for syncope. DESIGN: One-year prospective cohort study. SETTING: Single academic ED. PARTICIPANTS: Adult patients with an ED complaint of syncope or near-syncope. MEASUREMENTS: Treating physicians prospectively recorded the presence or absence of potential risk factors for serious clinical events. Patients were contacted by telephone at 14 days for a structured interview. A three-physician panel reviewed ED charts, hospital records, and telephone interview forms to identify predefined events. The primary outcome included any 14-day predefined event. A secondary outcome included any 14-day predefined event that was first diagnosed after the initial ED visit. Age was analyzed in 20-year intervals. Multivariate logistic regression controlled for baseline demographic, comorbidity, and electrocardiogram data. RESULTS: Of 592 eligible patients, 477 (81%) provided informed consent. Follow-up was successfully obtained for 463 (97%) patients. The age range was 18 to 96, and 47% of patients were aged 60 and older. There were 80 (17%) patients who had a 14-day event, including 18 (4%) with a delayed diagnosis. Compared with patients aged 18 to 39, the adjusted odds ratio (OR) of a serious outcome was 2.7 (95% confidence interval (CI)=0.9-8.4) for patient aged 40 to 59, 3.8 (95% CI=1.3-12) for patients aged 60 to 79, and 3.8 (95% CI=1.2-12) for patients aged 80 and older. CONCLUSION: Age of 60 and older is strongly associated with short-term serious events after an ED visit for syncope.
Authors: Carol L Clark; Thomas A Gibson; Robert E Weiss; Annick N Yagapen; Susan E Malveau; David H Adler; Aveh Bastani; Christopher W Baugh; Jeffrey M Caterino; Deborah B Diercks; Judd E Hollander; Bret A Nicks; Daniel K Nishijima; Manish N Shah; Kirk A Stiffler; Alan B Storrow; Scott T Wilber; Benjamin C Sun Journal: Acad Emerg Med Date: 2019-03-04 Impact factor: 3.451
Authors: Benjamin C Sun; Stephen F Derose; Li-Jung Liang; Gelareh Z Gabayan; Jerome R Hoffman; Alison A Moore; William R Mower; Carol M Mangione Journal: Ann Emerg Med Date: 2009-09-19 Impact factor: 5.721
Authors: Benjamin C Sun; Heather McCreath; Li-Jung Liang; Stephen Bohan; Christopher Baugh; Luna Ragsdale; Sean O Henderson; Carol Clark; Aveh Bastani; Emmett Keeler; Ruopeng An; Carol M Mangione Journal: Ann Emerg Med Date: 2013-11-13 Impact factor: 5.721
Authors: Gelareh Z Gabayan; Stephen F Derose; Steven M Asch; Vicki Y Chiu; Sungching C Glenn; Carol M Mangione; Benjamin C Sun Journal: Am J Cardiol Date: 2010-01-01 Impact factor: 2.778