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Syncope Evaluation in the Emergency Department Study (SEEDS): A Multidisciplinary Approach to Syncope Management
Open accessAbstract
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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“In this setting, a structured ED protocol can be effective as an alternative to inpatient admission (107–110).”
From 2017 ACC/AHA/HRS Guideline for the Evaluation and Management of Patients With Syncope (2017) · cites this paper as [107]
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Metadata
- 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
- Venue
- Circulation
- Published
- 2004-12-14
- Volume
- 110
- Issue
- 24
- Pages
- 3636-3645
- ISSN
- 0009-7322 (ISSN-L)
- 1524-4539
- 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
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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