Short- and Long-Term Prognosis of Syncope, Risk Factors, and Role of Hospital Admission
Open accessAbstract
Objective We sought to assess short- and long-term prognosis of syncope and associated risk factors.Background Syncope is a common clinical event, but our knowledge of its short-term outcome is largely incomplete. Further, it is unknown whether hospital admission might positively affect a patient's syncope prognosis.Methods We screened 2,775 consecutive subjects who presented for syncope at 4 emergency departments between January and July 2004. Short- and long-term severe outcomes (i.e., death and major therapeutic procedures) and related risk factors were compared in all enrolled patients arrayed according to hospital admission or discharge.Results A total of 676 subjects were included in the study. Forty-one subjects (6.1%) experienced severe outcomes (5 deaths, 0.7%; 36 major therapeutic procedures, 5.4%) in the 10 days after presentation. An abnormal electrocardiogram, concomitant trauma, absence of symptoms of impending syncope, and male gender were associated with short-term unfavorable outcomes. Long-term severe outcomes were 9.3% (40 deaths, 6.0%; 22 major therapeutic procedures, 3.3%), and their occurrence was correlated with an age >65 years, history of neoplasms, cerebrovascular diseases, structural heart diseases, and ventricular arrhythmias. Short-term major therapeutic procedures were more common (p < 0.05) in subjects who had been admitted to hospital (13.3%) than in discharged (1.6%), whereas mortality was similar. One-year mortality was greater (p < 0.05) in admitted (14.7%) than in discharged (1.8%) patients.Conclusions Risk factors for short- and long-term adverse outcomes after syncope differed. Hospital admission favorably influenced syncope short term prognosis. Instead, 1-year mortality was unaffected by hospital admission and related to comorbidity.
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A few prospective studies developed clinical decision tools to identify patients at risk of serious adverse events within 30 days.
“A few prospective studies developed clinical decision tools to identify patients at risk of serious adverse events within 30 days. 8,9,13,14”
From Development of the Canadian Syncope Risk Score to predict serious adverse events after emergency department assessment of syncope (2016) · cites this paper as [14]
The Abstract (page not provided) describes a prospective study of predictors of adverse events after syncope, and the Results identify short-term risk factors. But this paper assessed outcomes within 10 days, not 30, and does not report developing a clinical decision tool. (LLM, conf=0.86)
Experimental — accuracy not yet measuredThe existing clinical decision tools for syncope have poor diagnostic test characteristics and several methodological flaws that preclude their widespread adoption by clinicians.
“However, they have poor diagnostic test characteristics and several methodological flaws that preclude their widespread adoption by clinicians.”
From Development of the Canadian Syncope Risk Score to predict serious adverse events after emergency department assessment of syncope (2016) · cites this paper as [14]
The Long-term mortality and severe outcomes section identifies a methodological concern: emergency-setting prognostic scores based on 6- or 12-month outcomes may be misleading for immediate risk assessment unless validated for the short term. It does not report that existing tools have poor diagnostic test characteristics or say that these limitations preclude their widespread adoption by clinicians. The Study limitations section discusses limitations of the authors’ own study, not of existing tools. (LLM, conf=0.83)
Experimental — accuracy not yet measuredFive prospective syncope studies attempted to develop tools for identification of short-term risk of serious adverse events.
“Five prospective syncope studies attempted to develop tools for identification of short-term risk of serious adverse events. 8,9,13,14,26”
From Development of the Canadian Syncope Risk Score to predict serious adverse events after emergency department assessment of syncope (2016) · cites this paper as [14]
The Population and Results sections describe a prospective syncope study that analyzed predictors of severe outcomes within 10 days and identified independent risk factors. Our copy does not show that the authors developed a risk-identification tool or score; that part of the characterization is unsupported. This citation identifies one study, so it need not establish the total of five. (LLM, conf=0.84)
Experimental — accuracy not yet measuredClinical decision rules can predict poor outcomes, but most syncope deaths and many poor outcomes are associated with underlying illness rather than syncope per se, particularly in the long term.
“Clinical decision rules can predict poor outcomes, but most syncope deaths and many poor outcomes are associated with underlying illness rather than syncope per se , 58 particularly in the long term. 56”
From 2018 ESC Guidelines for the diagnosis and management of syncope (2018) · cites this paper as [56]
Several previous prospective studies have reported heart disease and abnormal ECG findings as independent risk factors for serious outcomes among patients with syncope.
“Several previous prospective studies have reported heart disease and abnormal ECG findings as independent risk factors for serious outcomes among patients with syncope. 13,14,29”
From Development of the Canadian Syncope Risk Score to predict serious adverse events after emergency department assessment of syncope (2016) · cites this paper as [14]
The STePS Study identified risk factors for death and therapeutic interventions within 10 days.
“The Short-Term Prognosis in Syncope (STePS) Study identified risk factors for death and therapeutic interventions within 10 days. 14”
From Development of the Canadian Syncope Risk Score to predict serious adverse events after emergency department assessment of syncope (2016) · cites this paper as [14]
Three of the studies included readmission to hospital without identification of serious underlying conditions as an outcome.
“Three of the studies 13,14,26 included re admission to hospital without identification of serious underlying conditions as an outcome.”
From Development of the Canadian Syncope Risk Score to predict serious adverse events after emergency department assessment of syncope (2016) · cites this paper as [14]
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Developed in collaboration with, European Heart Rhythm Association (EHRA), Heart Failure Association (HFA), and Heart Rhythm Society (HRS), societies, E. B. T. F., European Society of Emergency Medicine (EuSEM), European Federation of Internal Medicine (EFIM), European Union Geriatric Medicine Society (EUGMS), American Geriatrics Society (AGS), European Neurological Society (ENS), et al. (2009) · European Heart Journal · doi:10.1093/eurheartj/ehp298 · Cited by 2,040 · see citing works
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“Impact of Syncope on Quality of Life ......................................................................................”
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“The hospitals were chosen among those participating in the Short-Term Prognosis of Syncope (STePS) study [16] because of automatic access to laboratory data required to compute the SFSR.”
BackgroundMethodInfluentialSelf-citationErweiterte lebensrettende Maßnahmen für Erwachsene
Soar, J., Böttiger, B. W., Carli, P. A., Couper, K., Deakin, C. D., Djärv, T., Lott, C., Olasveengen, T. M., Paal, P., Pellis, T., et al. (2021) · Notfall + Rettungsmedizin · doi:10.1007/s10049-021-00893-x · Cited by 68 · see citing works
Prevalence of Pulmonary Embolism in Patients With Syncope
Costantino, G., Ruwald, M. H., Quinn, J., Camargo, C. A., Dalgaard, F., Gislason, G., Goto, T., Hasegawa, K., Kaul, P., Montano, N., et al. (2018) · JAMA Internal Medicine · doi:10.1001/jamainternmed.2017.8175 · Cited by 66 · see citing works
“The databases analyzed included (1) all inhabitants of the province of Alberta, Canada; (2) all inhabitants of Denmark; (3) all inhabitants of the metropolitan area of Milan, Italy; (4) data from the US Healthcare Cost and Utilization Project; and (5) data from a large US national insurance provider (Clinformatics Dat…”
MethodSelf-citationSyncope: Classification and risk stratification
Puppala, V. K., Dickinson, O., & Benditt, D. G. (2014) · Journal of Cardiology · doi:10.1016/j.jjcc.2013.03.019 · Cited by 64 · see citing works
Benditt, D. G., & Nguyen, J. T. (2009) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2008.12.065 · Cited by 55 · see citing works
Outcomes in Canadian Emergency Department Syncope Patients – Are We Doing a Good Job?
Thiruganasambandamoorthy, V., Hess, E. P., Turko, E., Perry, J. J., Wells, G. A., & Stiell, I. G. (2013) · The Journal of Emergency Medicine · doi:10.1016/j.jemermed.2012.06.028 · Cited by 53 · see citing works
Duration of Electrocardiographic Monitoring of Emergency Department Patients With Syncope
Thiruganasambandamoorthy, V., Rowe, B. H., Sivilotti, M. L. A., McRae, A. D., Arcot, K., Nemnom, M., Huang, L., Mukarram, M. A., Krahn, A. D., Wells, G. A., et al. (2019) · Circulation · doi:10.1161/circulationaha.118.036088 · Cited by 53 · see citing works
Syncope: Diagnosis and Management
Walsh, K., Hoffmayer, K. S., & Hamdan, M. H. (2014) · Current Problems in Cardiology · doi:10.1016/j.cpcardiol.2014.11.001 · Cited by 49 · see citing works
Daccarett, M., Jetter, T. L., Wasmund, S. L., Brignole, M., & Hamdan, M. H. (2011) · Europace · doi:10.1093/europace/eur201 · Cited by 58 · see citing works
“(7) LBBB or RBBB+left/right axis deviation (8) Long-QT pattern (9) Brugada pattern (10) ARVD pattern (11) WPW pattern 12-lead standard ECG Cardiac-Ischaemic causes (12) Cardiac ischaemia Chest pain and troponin abnormal Cardiovascular and pulmonary structural causes (13) Prolapsing atrial myxoma, tumour (14) Severe ao…”
BackgroundBerecki-Gisolf, J., SHELDON, A. G., Wieling, W., van Dijk, N., Costantino, G., Furlan, R., Shen, W.-K., & Sheldon, R. S. (2013) · PLoS ONE · doi:10.1371/journal.pone.0075255 · Cited by 44 · see citing works
“Fitting the test datasets to the full model gave C-statistics of 0.87 (Calgary), 0.84 (Amsterdam), 0.72 (Milan) and 0.71 (Rochester).”
BackgroundMethodInfluentialSelf-citationCanadian Cardiovascular Society Clinical Practice Update on the Assessment and Management of Syncope
Sandhu, R. K., Raj, S. R., Thiruganasambandamoorthy, V., Kaul, P., Morillo, C. A., Krahn, A. D., Guzmán, J. C., Sheldon, R. S., Banijamali, H. S., Macintyre, C. J., et al. (2020) · Canadian Journal of Cardiology · doi:10.1016/j.cjca.2019.12.023 · Cited by 42 · see citing works
Fahreignung bei kardiovaskulären Erkrankungen
Klein, H. H., Krämer, A., Pieske, B. M., Trappe, H., & de Vries, H. (2010) · Der Kardiologe · doi:10.1007/s12181-010-0308-9 · Cited by 41 · see citing works
Value of history taking in children and adolescents with cardiac syncope
Zhang, Q., Zhu, L., Wang, C., Du, Z., Hu, X., Tian, H., Ochs, T., Zhang, F., Du, J., & Jin, H. (2012) · Cardiology in the Young · doi:10.1017/s1047951112000303 · Cited by 37 · see citing works
Cardiac and Vascular Sympathetic Baroreflex Control during Orthostatic Pre-Syncope
Furlan, R., Heusser, K., Minonzio, M., Shiffer, D., Cairo, B., Tank, J., Jordan, J., Diedrich, A., Gauger, P., Zamunér, A. R., et al. (2019) · Journal of Clinical Medicine · doi:10.3390/jcm8091434 · Cited by 37 · see citing works
“, in the upright position, is common accounting for up to 74% of total syncope seen in emergency departments [2].”
BackgroundSelf-citationPrevalence of Pulmonary Embolism in Patients With Syncope
Badertscher, P., de Lavallaz, J. D. F., Hammerer‐Lercher, A., Nestelberger, T., Zimmermann, T., Geiger, M., Imahorn, O., Miró, Ò., Salgado, E., Christ, M., et al. (2019) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2019.06.020 · Cited by 37 · see citing works
Prognostic value of cardiac biomarkers in the risk stratification of syncope: a systematic review
Thiruganasambandamoorthy, V., Ramaekers, R., Rahman, M. O., Stiell, I. G., Sikora, L., Kelly, S.-L., Christ, M., Claret, P.-G., & Reed, M. J. (2015) · Internal and Emergency Medicine · doi:10.1007/s11739-015-1318-1 · Cited by 36 · see citing works
“Hospitalization of patients at risk for MACE is highly variable, and an important proportion will suffer events including deaths outside the hospital [7, 9, 13].”
BackgroundNational Cost Savings From Observation Unit Management of Syncope
Baugh, C. W., Liang, L.-J., Probst, M. A., & Sun, B. (2015) · Academic Emergency Medicine · doi:10.1111/acem.12720 · Cited by 36 · see citing works
“In addition, currently available risk stratification tools to identify syncope patients at intermediate risk may not be more accurate than clinical gestalt, but ongoing efforts are aimed at creating better tools.(33,34) In our model, we assumed that observation units are at maximum availability, which varies by size (…”
BackgroundNT-pro-BNP for diagnostic and prognostic evaluation in patients hospitalized for syncope
Pfister, R., Hagemeister, J., Esser, S., Hellmich, M., Erdmann, E., & Schneider, C. A. (2012) · International Journal of Cardiology · doi:10.1016/j.ijcard.2010.10.013 · Cited by 35 · see citing works
“As shown in the STePS study, admitted patients significantly differ from the total ED population and from discharged patients with respect to age, comorbidity and prognosis, and therefore, single risk factors might not be interchangeable between different populations [17].”
BackgroundSule, S., Palaniswamy, C., Aronow, W. S., Ahn, C., Peterson, S. J., Adapa, S., & Mudambi, L. (2011) · Clinical Cardiology · doi:10.1002/clc.20872 · Cited by 35 · see citing works
Updated Geriatric Cardiology Guidelines of the Brazilian Society of Cardiology - 2019
Moreira, A. A. C. D. M., Costa, E. F. D. A., Miranda, R. D., Wajngarten, M., Galera, S. C., Filho, A. C. D. A., Toledo, M. A. D. V., Alves, J. D. C., Moriguchi, E. H., Rodrigues, N. L., et al. (2019) · Arquivos Brasileiros de Cardiologia · doi:10.5935/abc.20190086 · Cited by 36 · see citing works
Shen, W.-K., Sheldon, R. S., Benditt, D. G., Cohen, M. I., Forman, D. E., Goldberger, Z. D., Grubb, B. P., Hamdan, M. H., Krahn, A. D., Link, M. S., et al. (2017) · Heart Rhythm · doi:10.1016/j.hrthm.2017.03.005 · Cited by 34 · see citing works
“IIb B-NR Use of risk stratification scores may be reasonable in the management of patients with syncope.(67,68,72,73,75,87,89,100,101)”
BackgroundRisk stratification of syncope: Current syncope guidelines and beyond
Sutton, R., Ricci, F., & Fedorowski, A. (2021) · Autonomic Neuroscience · doi:10.1016/j.autneu.2021.102929 · Cited by 35 · see citing works
“…(EGSYS) score (Del Rosso et al., 2008), the Boston Syncope Criteria (Grossman et al., 2007), the Short-Term Prognosis of Syncope (STePS) score (Costantino et al., 2008), the FAINT score (Probst et al., 2020) and the Basel IX ECG ALERT-CS tool (Zimmermann et al., 2021) - using various…”
MethodKey challenges in the current management of syncope
Sutton, R., Brignole, M., & Benditt, D. G. (2012) · Nature Reviews Cardiology · doi:10.1038/nrcardio.2012.102 · Cited by 33 · see citing works
Thiruganasambandamoorthy, V., Taljaard, M., Stiell, I. G., Sivilotti, M. L. A., Murray, H., Vaidyanathan, A., Rowe, B. H., Calder, L. A., Lang, E., McRae, A., et al. (2015) · Internal and Emergency Medicine · doi:10.1007/s11739-015-1237-1 · Cited by 39 · see citing works
Patients With Syncope in a German Emergency Department
Güldner, S., Langada, V., Popp, S., Heppner, H. J., Mang, H., & Christ, M. (2012) · Deutsches Ärzteblatt international · doi:10.3238/arztebl.2012.0058 · Cited by 33 · see citing works
Artificial neural networks and risk stratification in emergency departments
Falavigna, G., Costantino, G., Furlan, R., Quinn, J., Ungar, A., & Ippoliti, R. (2018) · Internal and Emergency Medicine · doi:10.1007/s11739-018-1971-2 · Cited by 33 · see citing works
Self-citationReed, M. J., Henderson, S. S., Newby, D. E., & Gray, A. J. (2011) · Annals of Emergency Medicine · doi:10.1016/j.annemergmed.2010.12.021 · Cited by 32 · see citing works
Sandhu, R. K., Tran, D. T., Sheldon, R. S., & Kaul, P. (2017) · JACC. Clinical electrophysiology · doi:10.1016/j.jacep.2017.09.003 · Cited by 32 · see citing works
Incidence of Syncope During Pregnancy: Temporal Trends and Outcomes
Chatur, S., Islam, S., Moore, L. E., Sandhu, R. K., Sheldon, R. S., & Kaul, P. (2019) · Journal of the American Heart Association · doi:10.1161/jaha.118.011608 · Cited by 32 · see citing works
Dipaola, F., Gatti, M., Pacetti, V., Bottaccioli, A. G., Shiffer, D., Minonzio, M., Menè, R., Levra, A. G., Solbiati, M., Costantino, G., et al. (2019) · Journal of Clinical Medicine · doi:10.3390/jcm8101677 · Cited by 32 · see citing works
Self-citationSyncope in the Emergency Department
Sandhu, R. K., & Sheldon, R. S. (2019) · Frontiers in Cardiovascular Medicine · doi:10.3389/fcvm.2019.00180 · Cited by 31 · see citing works
“An Italian study (31) evaluating mortality based on disposition found 1.”
BackgroundPredictors of Short-Term (Seven-Day) Cardiac Outcomes After Emergency Department Visit for Syncope
Gabayan, G. Z., Derose, S. F., Asch, S. M., Chiu, V. Y., Glenn, S. C., Mangione, C. M., & Sun, B. (2009) · The American Journal of Cardiology · doi:10.1016/j.amjcard.2009.08.654 · Cited by 30 · see citing works
“In addition, we collected co-morbidity information from existing administrative data, which limited our ability to assess clinically important elements such as symptoms and examination findings.(2,4,7,8,15,18) Addition of such data could potentially improve the ability to predict short-term cardiac death and events.”
BackgroundMethodResultNeural networks as a tool to predict syncope risk in the Emergency Department
Costantino, G., Falavigna, G., Solbiati, M., Casagranda, I., Sun, B., Grossman, S. A., Quinn, J., Reed, M. J., Ungar, A., Montano, N., et al. (2016) · EP Europace · doi:10.1093/europace/euw336 · Cited by 31 · see citing works
“Two studies were conducted in Italy and one in the USA.(2,10,11)”
MethodSelf-citationSyncope: Outcomes and Conditions Associated with Hospitalization
Joy, P. S., Kumar, G., & Olshansky, B. (2017) · The American Journal of Medicine · doi:10.1016/j.amjmed.2016.12.030 · Cited by 29 · see citing works
Electrocardiogram Findings in Emergency Department Patients with Syncope
Quinn, J., & McDERMOTT, D. J. (2011) · Academic Emergency Medicine · doi:10.1111/j.1553-2712.2011.01120.x · Cited by 28 · see citing works
Kadri, A. N., Abuamsha, H., Nusairat, L., Kadri, N., Abuissa, H. S., Masri, A., & Hernández, A. V. (2018) · Journal of the American Heart Association · doi:10.1161/jaha.118.009746 · Cited by 26 · see citing works
Syncope and risk of sudden cardiac arrest in coronary artery disease
Aro, A. L., Rusinaru, C., Uy‐Evanado, A., Reinier, K., Phan, D. Q., Gunson, K., Jui, J., & Chugh, S. S. (2016) · International Journal of Cardiology · doi:10.1016/j.ijcard.2016.12.021 · Cited by 27 · see citing works
Thiruganasambandamoorthy, V., Stiell, I. G., Sivilotti, M. L. A., Rowe, B. H., Mukarram, M. A., Arcot, K., Kwong, K., McRae, A. D., Wells, G. A., & Taljaard, M. (2017) · Academic Emergency Medicine · doi:10.1111/acem.13275 · Cited by 27 · see citing works
Arrhythmic syncope: From diagnosis to management
Pascual, J. F., Jordán, P., Silva, J. R., & Rivas‐Gándara, N. (2023) · World Journal of Cardiology · doi:10.4330/wjc.v15.i4.119 · Cited by 28 · see citing works
Approach to syncope in the emergency department
Reed, M. J. (2018) · Emergency Medicine Journal · doi:10.1136/emermed-2018-207767 · Cited by 26 · see citing works
“Currently, approximately 50% of patients who present to the ED with syncope (although the range is wide [11,17, 27-37]) [Table 1] are admitted, and this has not been changed with clinical decision rule use.”
BackgroundInternational Validation of the Canadian Syncope Risk Score
Zimmermann, T., de Lavallaz, J. D. F., Nestelberger, T., Gualandro, D. M., López‐Ayala, P., Badertscher, P., Widmer, V., Shrestha, S., Strebel, I., Glarner, N., et al. (2022) · Annals of Internal Medicine · doi:10.7326/m21-2313 · Cited by 25 · see citing works
The Emergency Department Approach to Syncope: Evidence-based Guidelines and Prediction Rules
Kessler, C. S., Tristano, J. M., & Lorenzo, R. A. D. (2010) · Emergency Medicine Clinics of North America · doi:10.1016/j.emc.2010.03.014 · Cited by 25 · see citing works
Driving and Working with Syncope
Barbic, F., Casazza, G., Zamunér, A. R., Costantino, G., Orlandi, M., Dipaola, F., Capitanio, C., Achenza, S., Sheldon, R., & Furlan, R. (2014) · Autonomic Neuroscience · doi:10.1016/j.autneu.2014.05.006 · Cited by 23 · see citing works
Self-citationNumeroso, F., Mossini, G., Giovanelli, M., Lippi, G., & Cervellin, G. (2016) · Academic Emergency Medicine · doi:10.1111/acem.13013 · Cited by 24 · see citing works
Syncope in adults: Systematic review and proposal of a diagnostic and therapeutic algorithm
Rosanio, S., Schwarz, E. R., Ware, D. L., & Vitarelli, A. (2011) · International Journal of Cardiology · doi:10.1016/j.ijcard.2011.11.021 · Cited by 24 · see citing works
Predictors of Short-Term Outcomes after Syncope: A Systematic Review and Meta-Analysis
Gibson, T. A., Weiss, R., & Sun, B. (2018) · Western Journal of Emergency Medicine · doi:10.5811/westjem.2018.2.37100 · Cited by 24 · see citing works
Syncope Risk Stratification in the Emergency Department
Costantino, G., & Furlan, R. (2012) · Cardiology Clinics · doi:10.1016/j.ccl.2012.10.003 · Cited by 24 · see citing works
“The overall risk for a patient entering the ED because of syncope is between 5% and 15%, and the mortality at 1 week is about 1%.(5,7,8,10,11) The primary goal of the ED physician is thus to discriminate individuals at low risk who can be safely discharged, from patients at high risk who require prompt hospitalization…”
Self-citationProspective validation of prognostic and diagnostic syncope scores in the emergency department
de Lavallaz, J. D. F., Badertscher, P., Nestelberger, T., Isenrich, R., Miró, Ò., Salgado, E., Geigy, N., Christ, M., Cullen, L., Than, M. P., et al. (2018) · International Journal of Cardiology · doi:10.1016/j.ijcard.2018.06.088 · Cited by 24 · see citing works
Anderson, K. L., Limkakeng, A. T., Damuth, E., & Chandra, A. B. (2012) · Annals of Emergency Medicine · doi:10.1016/j.annemergmed.2012.04.023 · Cited by 23 · see citing works
Syncope in the Emergency Department: A Practical Approach
Furlan, L., Jacobitti, G., Gianni, F., Solbiati, M., Mancusi, C., & Costantino, G. (2024) · Journal of Clinical Medicine · doi:10.3390/jcm13113231 · Cited by 22 · see citing works
“The STePS study [78] has, indeed, provided evidence that hospitalization may positively affect the short-term but not the long-term (1 year) prognosis.”
BackgroundSelf-citationRuwald, M. H., & Zaręba, W. (2013) · Progress in Cardiovascular Diseases · doi:10.1016/j.pcad.2013.08.007 · Cited by 22 · see citing works
Validation of EGSYS Score in Prediction of Cardiogenic Syncope
Kariman, H., Harati, S., Safari, S., Baratloo, A., & Pishgahi, M. (2015) · Emergency Medicine International · doi:10.1155/2015/515370 · Cited by 23 · see citing works
Nationwide Trends in Syncope Hospitalizations and Outcomes From 2004 to 2014
Sandhu, R. K., Sheldon, R. S., Savu, A., & Kaul, P. (2016) · Canadian Journal of Cardiology · doi:10.1016/j.cjca.2016.11.005 · Cited by 21 · see citing works
Ruwald, M. H., Numé, A., Lamberts, M., Hansen, C. M., Hansen, M. L., Vinther, M., Køber, L., Torp-Pedersen, C. T., Hansen, J., & Gislason, G. (2014) · The American Journal of Cardiology · doi:10.1016/j.amjcard.2014.02.035 · Cited by 21 · see citing works
Initial Evaluation of “Syncope and Collapse”
Benditt, D. G., & Can, I. (2010) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2009.09.050 · Cited by 21 · see citing works
Derose, S. F., Gabayan, G. Z., Chiu, V. Y., & Sun, B. (2012) · Academic Emergency Medicine · doi:10.1111/j.1553-2712.2012.01336.x · Cited by 20 · see citing works
Solbiati, M., Dipaola, F., Villa, P., Seghezzi, S., Casagranda, I., Rabajoli, F., Fiorini, E., Porta, L., Casazza, G., Voza, A., et al. (2019) · Academic Emergency Medicine · doi:10.1111/acem.13842 · Cited by 20 · see citing works
Self-citationInfluence of Climate on Emergency Department Visits for Syncope: Role of Air Temperature Variability
Galli, A., Barbic, F., Borella, M., Costantino, G., Perego, F., Dipaola, F., Casella, F., Duca, P., Diedrich, A., Raj, S. R., et al. (2011) · PLoS ONE · doi:10.1371/journal.pone.0022719 · Cited by 20 · see citing works
Self-citationThiruganasambandamoorthy, V., Sivilotti, M. L. A., Rowe, B. H., McRae, A. D., Mukarram, M. A., Malveau, S. E., Yagapen, A. N., Sun, B., Nemnom, M., Huang, L., et al. (2019) · Annals of Emergency Medicine · doi:10.1016/j.annemergmed.2018.12.005 · Cited by 20 · see citing works
“2%) and in one previous syncope study that reported this comorbidity.(20) A meta-analysis by Dentali et al(21) reported a 3.”
BackgroundApproach to the Patient with Syncope
Benditt, D. G., & Adkisson, W. O. (2012) · Cardiology Clinics · doi:10.1016/j.ccl.2012.09.002 · Cited by 19 · see citing works
Diagnostic and Prognostic Value of High-sensitivity Cardiac Troponin T in Patients with Syncope
Christ, M., Geier, F., Popp, S., Singler, K., Smolarsky, A., Bertsch, T., Mueller, C. E., & Greve, Y. (2014) · The American Journal of Medicine · doi:10.1016/j.amjmed.2014.09.021 · Cited by 19 · see citing works
Bernier, R., Tran, D. T., Sheldon, R. S., Kaul, P., & Sandhu, R. K. (2020) · JACC. Clinical electrophysiology · doi:10.1016/j.jacep.2019.11.002 · Cited by 18 · see citing works
Casagranda, I., Costantino, G., Falavigna, G., Furlan, R., & Ippoliti, R. (2015) · Health Policy · doi:10.1016/j.healthpol.2015.12.003 · Cited by 18 · see citing works
Self-citationNT-pro-BNP for differential diagnosis in patients with syncope
Costantino, G., Solbiati, M., Pisano, G., & Furlan, R. (2008) · International Journal of Cardiology · doi:10.1016/j.ijcard.2008.05.051 · Cited by 18 · see citing works
Self-citationThe Prevalence and Prognostic Significance of Near Syncope and Syncope
Greve, Y., Geier, F., Popp, S., Bertsch, T., Singler, K., Meier, F., Smolarsky, A., Mang, H., Mueller, C. E., & Christ, M. (2014) · Deutsches Ärzteblatt international · doi:10.3238/arztebl.2014.0197 · Cited by 17 · see citing works
“Italian working groups report an adverse event rate of 5 to 6% after 10 days (13, 27), while US emergency physicians state a rate of 11.”
BackgroundThe Dilemma of Falls in Older Persons: Never Forget to Investigate the Syncope
Perego, F., MARIA, B. D., Bagnara, L., Grazia, V. D., Monelli, M., Cesari, M., & Vecchia, L. A. D. (2021) · Medicina · doi:10.3390/medicina57060623 · Cited by 17 · see citing works
“Conversely, syncope should be identified and stratified by the degree of the risk of severe adverse outcomes over the short- and long-term periods [18].”
BackgroundSelf-citationOutcomes in syncope research: a systematic review and critical appraisal
Solbiati, M., Bozzano, V., Barbic, F., Casazza, G., Dipaola, F., Quinn, J., Reed, M. J., Sheldon, R. S., Shen, W.-K., Sun, B., et al. (2018) · Internal and Emergency Medicine · doi:10.1007/s11739-018-1788-z · Cited by 17 · see citing works
Self-citationHow can we improve management of syncope in the Emergency Department?
Probst, M. A., & Sun, B. (2014) · Cardiology Journal · doi:10.5603/cj.a2014.0074 · Cited by 17 · see citing works
“To address this gap, multiple syncope risk-stratification tools have been developed with a goal of identifying patients who can safely be discharged from the ED [5, 10–14].”
BackgroundIs hospital admission valuable in managing syncope? Results from the STePS study
Costantino, G., Dipaola, F., Solbiati, M., Bulgheroni, M., Barbic, F., & Furlan, R. (2014) · Cardiology Journal · doi:10.5603/cj.a2014.0071 · Cited by 16 · see citing works
“The Short-term Prognosis of Syncope (STePS) study [15] was specifically designed to test if hospitalization could be useful in patients with syncope.”
BackgroundSelf-citationHRS Policy Statement: Clinical Cardiac Electrophysiology Fellowship Curriculum: Update 2011
Link, M. S., Exner, D. V., Anderson, M. E., Ackerman, M., Al‐Ahmad, A., Knight, B. P., Markowitz, S. M., Kaufman, E. S., Haines, D. E., Asirvatham, S. J., et al. (2011) · Heart Rhythm · doi:10.1016/j.hrthm.2011.06.008 · Cited by 16 · see citing works
- Authors
- Costantino, G., Perego, F., Dipaola, F., Borella, M., Galli, A., Cantoni, G., Dell’Orto, S., Dassi, S., Filardo, N., Duca, P. G., Montano, N., & Furlan, R.
- Affiliations
- University of Milan (IT)
- Corresponding author
- Furlan, Raffaello
- Venue
- Journal of the American College of Cardiology
- Publisher
- Elsevier BV
- Published
- 2008-01
- Volume
- 51
- Issue
- 3
- Pages
- 276-283
- ISSN
- 0735-1097 (ISSN-L)
- OpenAlex
- W2169409503
- Cited by
- 246
- References
- 33
- Citations by year
- 2026: 1 · 2025: 6 · 2024: 2 · 2023: 7 · 2022: 7 · 2021: 10 · 2020: 12 · 2019: 15 · 2018: 19 · 2017: 22 · 2016: 18 · 2015: 12 · 2014: 27 · 2013: 19 · 2012: 19
- FWCI
- 17.56
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Journal of the American College of Cardiology (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Regione Lombardia
- Topics
- Health Sciences › Medicine › Surgery › Cardiovascular Syncope and Autonomic Disorders
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac electrophysiology and arrhythmias
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Takotsubo Cardiomyopathy and Associated Phenomena
- Keywords
- syncope, prognosis, risk factors, hospitalization, mortality, electrocardiographic abnormalities, comorbidities, ventricular arrhythmias, structural heart disease, cerebrovascular disease, emergency department patients
- MeSH terms
- Adult, Age Factors, Aged, Analysis of Variance, Arrhythmias, Cardiac, Cardiovascular Diseases, Cause of Death, Female, Hospitalization, Humans, Male, Middle Aged, Prognosis, Prospective Studies, Risk Factors, Syncope, Comorbidity
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