BACKGROUND: Little is known about the outcomes of adults with syncope seen in Canadian Emergency Departments (EDs). OBJECTIVES: We sought to determine the frequency, timing, and type of serious adverse outcomes occurring in these patients, and the proportion that occur outside the hospital. METHODS: We conducted a health records review of syncope patients presenting to a tertiary care ED over an 18-month period. We included all patients older than 16 years of age who fulfilled the syncope definition (sudden transient loss of consciousness with spontaneous complete recovery), and excluded those with altered mental status, alcohol or illicit drug use, seizure, or trauma. We assessed for outcomes in the ED and after ED disposition. We also evaluated follow-up arrangements for patients discharged from the ED. RESULTS: Of the total 87,508 patient visits, 505 (0.6%) were due to syncope. The mean age was 58.5 years (range 16-101 years), 70.1% arrived by ambulance, and 12.3% were admitted to the hospital. Five patients died: 2 in the ED, 1 as an inpatient, and 2 after discharge. Overall, there were 49 (9.7%) serious outcomes, with dysrhythmias being the most common (4.6%); 22 (4.4%) occurred in the ED, 15 (3.0%) in the hospital, and 12 (2.4%) outside the hospital. Eight serious outcomes occurred in patients discharged from the ED without any planned follow-up. CONCLUSION: Although syncope represented < 1% of all patient visits, morbidity was substantial, particularly in patients discharged from the ED. Future research should help clinicians identify syncope patients at high risk for serious outcomes.
BACKGROUND: Little is known about the outcomes of adults with syncope seen in Canadian Emergency Departments (EDs). OBJECTIVES: We sought to determine the frequency, timing, and type of serious adverse outcomes occurring in these patients, and the proportion that occur outside the hospital. METHODS: We conducted a health records review of syncopepatients presenting to a tertiary care ED over an 18-month period. We included all patients older than 16 years of age who fulfilled the syncope definition (sudden transient loss of consciousness with spontaneous complete recovery), and excluded those with altered mental status, alcohol or illicit drug use, seizure, or trauma. We assessed for outcomes in the ED and after ED disposition. We also evaluated follow-up arrangements for patients discharged from the ED. RESULTS: Of the total 87,508 patient visits, 505 (0.6%) were due to syncope. The mean age was 58.5 years (range 16-101 years), 70.1% arrived by ambulance, and 12.3% were admitted to the hospital. Five patients died: 2 in the ED, 1 as an inpatient, and 2 after discharge. Overall, there were 49 (9.7%) serious outcomes, with dysrhythmias being the most common (4.6%); 22 (4.4%) occurred in the ED, 15 (3.0%) in the hospital, and 12 (2.4%) outside the hospital. Eight serious outcomes occurred in patients discharged from the ED without any planned follow-up. CONCLUSION: Although syncope represented < 1% of all patient visits, morbidity was substantial, particularly in patients discharged from the ED. Future research should help clinicians identify syncopepatients at high risk for serious outcomes.
Authors: Giorgio Costantino; Benjamin C Sun; Franca Barbic; Ilaria Bossi; Giovanni Casazza; Franca Dipaola; Daniel McDermott; James Quinn; Matthew J Reed; Robert S Sheldon; Monica Solbiati; Venkatesh Thiruganasambandamoorthy; Daniel Beach; Nicolai Bodemer; Michele Brignole; Ivo Casagranda; Attilio Del Rosso; Piergiorgio Duca; Greta Falavigna; Shamai A Grossman; Roberto Ippoliti; Andrew D Krahn; Nicola Montano; Carlos A Morillo; Brian Olshansky; Satish R Raj; Martin H Ruwald; Francois P Sarasin; Win-Kuang Shen; Ian Stiell; Andrea Ungar; J Gert van Dijk; Nynke van Dijk; Wouter Wieling; Raffaello Furlan Journal: Eur Heart J Date: 2015-08-04 Impact factor: 29.983
Authors: Marc A Probst; Alexander T Janke; Adrian D Haimovich; Arjun K Venkatesh; Michelle P Lin; Keith E Kocher; Marie-Joe Nemnom; Venkatesh Thiruganasambandamoorthy Journal: Ann Emerg Med Date: 2022-04-27 Impact factor: 6.762
Authors: Venkatesh Thiruganasambandamoorthy; Monica Taljaard; Ian G Stiell; Marco L A Sivilotti; Heather Murray; Aparna Vaidyanathan; Brian H Rowe; Lisa A Calder; Eddy Lang; Andrew McRae; Robert Sheldon; George A Wells Journal: Intern Emerg Med Date: 2015-04-28 Impact factor: 3.397
Authors: Venkatesh Thiruganasambandamoorthy; Rosa Ramaekers; Mohammed Omair Rahman; Ian Gilmour Stiell; Lindsey Sikora; Sarah-Louise Kelly; Michael Christ; Pierre-Geraud Claret; Matthew James Reed Journal: Intern Emerg Med Date: 2015-10-23 Impact factor: 3.397
Authors: Venkatesh Thiruganasambandamoorthy; Ian G Stiell; Marco L A Sivilotti; Heather Murray; Brian H Rowe; Eddy Lang; Andrew McRae; Robert Sheldon; George A Wells Journal: BMC Emerg Med Date: 2014-03-14