Physical injuries caused by a transient loss of consciousness: main clinical characteristics of patients and diagnostic contribution of carotid sinus massage
Abstract
AIMS: To evaluate the prevalence and the characteristics of secondary trauma among patients referred to the emergency department (ED) for a transient loss of consciousness (TLOC). METHODS AND RESULTS: Over a 24 months period, all the patients referred to our ED for a TLOC were evaluated according to the ESC Guidelines on Syncope and enrolled in the study. Among 1253 consecutive patients with TLOC (1114 with a true syncope and 139 with a non-syncopal condition) 365 (29.1%) reported a trauma, in 59 cases (4.7%) severe. The frequency and the characteristics of trauma did not differ among the two main categories of TLOC. Out of 54 patients with syncope and a severe trauma, 20 (37%) had a definite diagnosis after a guidelines-based initial evaluation, and further 17 (31.5%) during the hospital course. Among these latter, carotid sinus syndrome was by far the most common diagnosis. CONCLUSION: Among patients referred to the ED for a TLOC secondary trauma is a common complication, whose characteristics are of little utility to discover the specific cause of the symptom. For older patients with syncope complicated by a severe trauma carotid sinus massage should be the first diagnostic manoeuvre to be undertaken after a non-diagnostic initial evaluation.
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The population in PICTURE was slightly younger and healthier than those in other syncope studies such as EaSyAS, EGSYS 2, and ISSUE 2.
“The population in PICTURE was slightly younger and healthier than those in other syncope studies such as EaSyAS,12 EGSYS 2,13 and ISSUE 2.14”
From Use of an implantable loop recorder to increase the diagnostic yield in unexplained syncope: results from the PICTURE registry (2011) · cites this paper as [14]
Cites
Preventing Falls in Elderly Persons
Tinetti, M. E. (2003) · New England Journal of Medicine · doi:10.1056/nejmcp020719 · Cited by 1,660 · see citing works
Carotid sinus syndrome: a modifiable risk factor for nonaccidental falls in older adults (SAFE PACE)
Kenny, R. A. M., Richardson, D. A., Steen, N., Bexton, R. S., Shaw, F. E., & Bond, J. (2001) · Journal of the American College of Cardiology · doi:10.1016/s0735-1097(01)01537-6 · Cited by 344 · see citing works
Management of patients with syncope referred urgently to general hospitals
Disertori, M. (2003) · Europace · doi:10.1016/s1099-5129(03)00049-7 · Cited by 153 · see citing works
Management of syncope referred urgently to general hospitals with and without syncope units
Brignole, M. (2003) · Europace · doi:10.1016/s1099-5129(03)00047-3 · Cited by 118 · see citing works
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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
Edvardsson, N., Frykman, V., van Mechelen, R., Mitro, P., Mohii-Oskarsson, A., Pasquie, J.-L., Ramanna, H., Schwertfeger, F., Ventura, R., Voulgaraki, D., et al. (2011) · Europace · doi:10.1093/europace/euq418 · Cited by 250 · see citing works
Linker, N. J., Voulgaraki, D., Garutti, C., Rieger, G., & Edvardsson, N. (2013) · International Journal of Cardiology · doi:10.1016/j.ijcard.2013.10.025 · Cited by 21 · see citing works
Palmisano, P., Guerra, F., Aspromonte, V., Dell’Era, G., Pellegrino, P. L., Laffi, M., Uran, C., De Bonis, S., Accogli, M., Dello Russo, A., et al. (2022) · Heart Rhythm · doi:10.1016/j.hrthm.2022.05.023 · Cited by 11 · see citing works
Do Implantable Loop Recorders Impact the Survival of Patients with Recurrent Unexplained Syncope?
Perings, C., Wolff, C., Wilk, A., Witthohn, A., Voss, R., & Rybak, K. (2021) · Journal of Comparative Effectiveness Research · doi:10.2217/cer-2020-0242 · Cited by 7 · see citing works
- Authors
- Bartoletti, A., Fabiani, P., Bagnoli, L., Cappelletti, C., Cappellini, M., Nappini, G., Gianni, R., Lavacchi, A., & Santoro, G. M.
- Affiliations
- Nuovo Ospedale San Giovanni di Dio (IT)
- Corresponding author
- Bartoletti, A.
- ORCID
- Cappellini, M.
- Venue
- European Heart Journal
- Publisher
- Oxford University Press (OUP)
- Published
- 2008-03-01
- Volume
- 29
- Issue
- 5
- Pages
- 618-624
- ISSN
- 0195-668X (ISSN-L)
- 1522-9645
- OpenAlex
- W2030299805
- Cited by
- 102
- References
- 4
- Citations by year
- 2026: 2 · 2025: 3 · 2024: 4 · 2023: 5 · 2022: 7 · 2021: 9 · 2020: 4 · 2019: 7 · 2018: 3 · 2017: 2 · 2016: 8 · 2015: 7 · 2014: 6 · 2013: 9 · 2012: 4
- FWCI
- 5.93
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- European Heart Journal (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Surgery › Cardiovascular Syncope and Autonomic Disorders
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Cerebrovascular and Carotid Artery Diseases
- Life Sciences › Neuroscience › Neurology › Vestibular and auditory disorders
- Keywords
- transient loss of consciousness, syncope, secondary traumatic stress, carotid sinus massage, carotid sinus syndrome, personal injury, emergency department evaluation, diagnostic workup, elderly patients
- MeSH terms
- Emergency Service, Hospital, Female, Heart Massage, Humans, Male, Middle Aged, Patient Admission, Syncope, Wounds and Injuries
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