Cited by 318Cardiovascular Syncope and Autonomic DisordersEmergency and Acute Care StudiesHeart Failure Treatment and Management

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Syncope Evaluation in the Emergency Department Study (SEEDS): A Multidisciplinary Approach to Syncope Management

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Shen, Win K., Decker, Wyatt W., Smars, Peter A., Goyal, Deepi G., Walker, Ann E., Hodge, David O., Trusty, Jane M., Brekke, Karen M., Jahangir, Arshad, Brady, Peter A., Munger, Thomas M., Gersh, Bernard J., Hammill, Stephen C., Frye, Robert L.·2004·Circulation

DOI 10.1161/01.cir.0000149236.92822.07

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Abstract

Background— The primary aim and central hypothesis of the study are that a designated syncope unit in the emergency department improves diagnostic yield and reduces hospital admission for patients with syncope who are at intermediate risk for an adverse cardiovascular outcome. Methods and Results— In this prospective, randomized, single-center study, patients were randomly allocated to 2 treatment arms: syncope unit evaluation and standard care. The 2 groups were compared with χ 2 test for independence of categorical variables. Wilcoxon rank sum test was used for continuous variables. Survival was estimated with the Kaplan-Meier method. One hundred three consecutive patients (53 women; mean age 64±17 years) entered the study. Fifty-one patients were randomized to the syncope unit. For the syncope unit and standard care patients, the presumptive diagnosis was established in 34 (67%) and 5 (10%) patients ( P <0.001), respectively, hospital admission was required for 22 (43%) and 51 (98%) patients ( P <0.001), and total patient-hospital days were reduced from 140 to 64. Actuarial survival was 97% and 90% ( P =0.30), and survival free from recurrent syncope was 88% and 89% ( P =0.72) at 2 years for the syncope unit and standard care groups, respectively. Conclusions— The novel syncope unit designed for this study significantly improved diagnostic yield in the emergency department and reduced hospital admission and total length of hospital stay without affecting recurrent syncope and all-cause mortality among intermediate-risk patients. Observations from the present study provide benchmark data for improving patient care and effectively utilizing healthcare resources.

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Authors: Shen, W. K., Decker, W. W., Smars, P. A., Goyal, D. G., Walker, A. E., Hodge, D. O., Trusty, J. M., Brekke, K. M., Jahangir, A., Brady, P. A., Munger, T. M., Gersh, B. J., Hammill, S. C., & Frye, R. L.
Affiliations: Mayo Clinic (US)
ORCID: Goyal, Deepi G.
Hodge, David O.
Jahangir, Arshad
Brady, Peter A.
Munger, Thomas M.
Gersh, Bernard J.
Frye, Robert L.
Venue: Circulation
Publisher: Ovid Technologies (Wolters Kluwer Health)
Published: 2004-12-14
Volume: 110
Issue: 24
Pages: 3636-3645
ISSN: 0009-7322 (ISSN-L)
1524-4539
DOI: 10.1161/01.cir.0000149236.92822.07
OpenAlex: W2116521722
Cited by: 318
References: 47
Citations by year: 2026: 8 · 2025: 5 · 2024: 6 · 2023: 9 · 2022: 8 · 2021: 11 · 2020: 12 · 2019: 11 · 2018: 19 · 2017: 23 · 2016: 11 · 2015: 20 · 2014: 18 · 2013: 24 · 2012: 19
FWCI: 11.62
Type: journal article
Language: en
Open access: bronze
doi.org
Locations: Circulation (publishedVersion)
PubMed (publishedVersion)
Funders: American Heart Association
Mayo Foundation for Medical Education and Research
National Institutes of Health
National Institute on Aging (R01AG021201, AG-21201)
National Heart, Lung, and Blood Institute (R01HL070302)
National Institute of Neurological Disorders and Stroke (P50NS032352)
Topics: Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Syncope and Autonomic Disorders
Health Sciences › Medicine › Emergency Medicine › Emergency and Acute Care Studies
Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Failure Treatment and Management
Keywords: syncope, syncope unit, emergency department, diagnostic yield, hospitalization, length of hospital stay, intermediate cardiovascular risk, recurrent syncope, all-cause mortality, healthcare resource utilization
MeSH terms: Aged, Ambulatory Care, Electrocardiography, Emergency Medical Services, Emergency Service, Hospital, Female, Follow-Up Studies, Hospitalization, Humans, Length of Stay, Male, Middle Aged, Prospective Studies, Recurrence, Syncope, Risk Assessment, Tilt-Table Test, Endpoint Determination

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Syncope Evaluation in the Emergency Department Study (SEEDS): A Multidisciplinary Approach to Syncope Management

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