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Multicenter Study
. 2009 Dec;54(6):769-778.e1-5.
doi: 10.1016/j.annemergmed.2009.07.027. Epub 2009 Sep 19.

Predictors of 30-day serious events in older patients with syncope

Benjamin C Sun  1 , Stephen F Derose, Li-Jung Liang, Gelareh Z Gabayan, Jerome R Hoffman, Alison A Moore, William R Mower, Carol M Mangione
Affiliations
Multicenter Study

Predictors of 30-day serious events in older patients with syncope

Benjamin C Sun et al. Ann Emerg Med. 2009 Dec.

Abstract

Study objective: We identify predictors of 30-day serious events after syncope in older adults.

Methods: We reviewed the medical records of older adults (age > or =60 years) who presented with syncope or near syncope to one of 3 emergency departments (EDs) between 2002 and 2005. Our primary outcome was occurrence of a predefined serious event within 30 days after ED evaluation. We used multivariable logistic regression to identify predictors of 30-day serious events.

Results: Of 3,727 potentially eligible patients, 2,871 (77%) met all eligibility criteria. We excluded an additional 287 patients who received a diagnosis of a serious clinical condition while in the ED. In the final study cohort (n=2,584), we identified 173 (7%) patients who experienced a 30-day serious event. High-risk predictors included age greater than 90 years, male sex, history of an arrhythmia, triage systolic blood pressure greater than 160 mm Hg, abnormal ECG result, and abnormal troponin I level. A low-risk predictor was a complaint of near syncope rather than syncope. A risk score, generated by summing high-risk predictors and subtracting the low-risk predictor, can stratify patients into low- (event rate 2.5%; 95% confidence interval [CI] 1.4% to 3.6%), intermediate- (event rate 6.3%; 95% CI 5.1% to 7.5%), and high-risk (event rate 20%; 95% CI 15% to 25%) groups.

Conclusion: We identified predictors of 30-day serious events after syncope in adults aged 60 years and greater. A simple score was able to stratify these patients into distinct risk groups and, if externally validated, might have the potential to aid ED decisionmaking.

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Figures

Figure 1
Figure 1
Calculating a Syncope Risk Score
Figure 2
Figure 2
Syncope Risk Score (SRS)
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References

    1. Sun BC, Emond JA, Camargo CA., Jr Characteristics and admission patterns of patients presenting with syncope to u.s. Emergency departments, 1992–2000. Acad Emerg Med. 2004 Oct;11(10):1029–1034. - PubMed
    1. Sun BC, Emond JA, Camargo CA., Jr Direct medical costs of syncope-related hospitalizations in the United States. Am J Cardiol. 2005 Mar 1;95(5):668–671. - PubMed
    1. Kapoor WN, Karpf M, Wieand S, Peterson JR, Levey GS. A prospective evaluation and follow-up of patients with syncope. N Engl J Med. 1983;309(4):197–204. - PubMed
    1. Lipsitz LA, Pluchino FC, Wei JY, Rowe JW. Syncope in institutionalized elderly: the impact of multiple pathological conditions and situational stress. J Chronic Dis. 1986;39(8):619–630. - PubMed
    1. Lipsitz LA, Wei JY, Rowe JW. Syncope in an elderly, institutionalised population: prevalence, incidence, and associated risk. Q J Med. 1985 Apr;55(216):45–54. - PubMed

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