Management of patients with syncope referred urgently to general hospitals
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OBJECTIVE: To evaluate the incidence and the strategy of management of syncope admitted urgently to a general hospital. BACKGROUND: The management of patients with syncope is not standardized. METHODS: The study was a prospective observational registry from a sample of 28 general hospitals in Italy and enroled all consecutive patients referred to their emergency rooms from November 5th 2001 to December 7th 2001 who were affected by transient loss of consciousness as the principal symptom. RESULTS: The incidence of syncope was 0.95% (996 of 105,173 patients attending). Forty-six percent were hospitalized, mostly in the Department of Internal Medicine. The mean in-hospital stay was 8.1+/-5.9 days. A mean of 3.48 tests was performed per patient. A definite diagnosis was made in 80% of cases, neurally-mediated syncope being the most frequent. The findings of each of the 28 hospitals participating in the survey were separately evaluated. We observed great inter-hospital and inter-department heterogeneity regarding the incidence of emergency admission, in-hospital pathways, most of the examinations performed and the final assigned diagnosis. For example, the execution of carotid sinus massage ranged from 0% in one hospital to 58% in another (median 12.5%); tilt testing ranged from 0 to 50% (median 5.8%); the final diagnosis of neurally-mediated syncope ranged from 10 to 78.6% (median 43.3%). CONCLUSION: Great inter-hospital and inter-department heterogeneity in the incidence and management of syncope was observed in general hospitals. As a consequence, we were unable to describe a uniform strategy for the management of syncope in everyday practice.
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The prevalence of syncope as a presenting symptom to the ED ranged from 0.8% to 2.4% in multiple studies in both academic and community settings.
“The prevalence of syncope as a presenting symptom to the ED ranged from 0.8% to 2.4% in multiple studies in both academic and community settings (49–55).”
From 2017 ACC/AHA/HRS Guideline for the Evaluation and Management of Patients With Syncope (2017) · cites this paper as [54]
The Results (page unavailable) report that syncope was the principal symptom for 996 of 105,173 emergency-department attendees, an incidence of 0.95%—within the claimed range. This study covers 28 general hospitals, but our copy does not establish the 0.8%–2.4% range across multiple studies in both academic and community settings. (LLM, conf=0.86)
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- Authors
- Disertori, M.
- Affiliations
- Ospedale Santa Chiara (IT)
- Corresponding author
- Disertori, M
- ORCID
- Disertori, M
- Venue
- Europace
- Publisher
- Oxford University Press (OUP)
- Published
- 2003-07
- Volume
- 5
- Issue
- 3
- Pages
- 283-291
- ISSN
- 1099-5129 (ISSN-L)
- OpenAlex
- W2158273748
- Cited by
- 153
- References
- 17
- Citations by year
- 2026: 1 · 2025: 3 · 2024: 2 · 2023: 1 · 2022: 4 · 2021: 2 · 2020: 5 · 2019: 2 · 2018: 9 · 2017: 8 · 2016: 6 · 2015: 9 · 2014: 12 · 2013: 16 · 2012: 7
- FWCI
- 6.09
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- EP Europace (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Surgery › Cardiovascular Syncope and Autonomic Disorders
- Life Sciences › Neuroscience › Neurology › Vestibular and auditory disorders
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Electrolyte and hormonal disorders
- Keywords
- syncope, neurally mediated syncope, emergency department admission, inpatient management, carotid sinus massage, tilt table test, diagnostic workup, interhospital variation, transient loss of consciousness, hospitalization
- MeSH terms
- Adult, Aged, Aged, 80 and over, Emergency Service, Hospital, Female, Hospitals, General, Humans, Italy, Male, Middle Aged, Practice Patterns, Physicians', Prospective Studies, Referral and Consultation, Registries, Syncope, Cohort Studies, Incidence
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