Evidence-based algorithms and the management of falls and syncope presenting to acute medical services
Open accessAbstract
Falls and syncope are symptoms that commonly present to medical services. Detailed international guidelines for their management are available but tend to be aimed at specialists rather than generalists. Novel, evidence-based algorithms for the management of these symptoms when they present to acute medical services were formulated and their impact on patient care audited. The percentage of people admitted with falls and syncope was unexpectedly high (10.6% at baseline); this had decreased to 8.2% at repeat audit. Readmission rates decreased from 12% at baseline audit to 0% in repeat audit, while length of inpatient stay was unchanged. Mortality was strikingly high (12%) in both audits. Although inappropriate use of investigations decreased, the use of appropriate management strategies increased. Easy-to-use algorithms can help reduce the number of patients admitted to acute medical services with falls and syncope while optimising the care of those managed as inpatients. The algorithms are provided for use by interested parties.
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Decision support algorithms may reduce health service use in the evaluation of syncope.
“Decision support algorithms may reduce health service use in the evaluation of syncope (Figures 1 and 2) (105,111–113), although there are currently insufficient data to advocate the use of specific decision support algorithms for making disposition decisions.”
From 2017 ACC/AHA/HRS Guideline for the Evaluation and Management of Patients With Syncope (2017) · cites this paper as [111]
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Research works printed but not linked: 16
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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
Self-citation2017 ACC/AHA/HRS Guideline for the Evaluation and Management of Patients With Syncope
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.2017.03.004 · Cited by 484 · see citing works
2017 ACC/AHA/HRS Guideline for the Evaluation and Management of Patients With Syncope
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) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2017.03.003 · Cited by 327 · see citing works
Brignole, M., Ungar, A., Casagranda, I., Gulizia, M., Lunati, M., Ammirati, F., Del Rosso, A., Sasdelli, M., Santini, M., Maggi, R., et al. (2010) · Europace · doi:10.1093/europace/eup370 · Cited by 133 · see citing works
- Authors
- Parry, S. W., Frearson, R., Steen, N., Newton, J. L., Tryambake, P., & Kenny, R. A.
- Affiliations
- Royal Victoria Infirmary (GB)
- Newcastle University (GB)
- Trinity College Dublin (IE)
- Venue
- Clinical Medicine
- Publisher
- Elsevier BV
- Published
- 2008-04
- Volume
- 8
- Issue
- 2
- Pages
- 157-162
- ISSN
- 1470-2118 (ISSN-L)
- PMC
- PMC4953000
- OpenAlex
- W2072357337
- Cited by
- 47
- References
- 0
- Citations by year
- 2023: 4 · 2022: 2 · 2019: 1 · 2018: 2 · 2017: 8 · 2016: 2 · 2015: 3 · 2014: 3 · 2013: 3 · 2012: 4
- FWCI
- 5.28
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Clinical Medicine (publishedVersion, cc-by-nc-nd)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Newcastle University ePrints (Newcastle Univesity)
- Topics
- Health Sciences › Medicine › Surgery › Cardiovascular Syncope and Autonomic Disorders
- Health Sciences › Health Professions › Physical Therapy, Sports Therapy and Rehabilitation › Balance, Gait, and Falls Prevention
- Health Sciences › Medicine › Emergency Medicine › Emergency and Acute Care Studies
- Keywords
- falls, syncope, clinical algorithms, hospitalization, hospital readmission, mortality, guideline adherence
- MeSH terms
- Accidental Falls, Adolescent, Adult, Aged, Aged, 80 and over, Algorithms, Female, United Kingdom, Humans, Internal Medicine, Male, Medical Audit, Middle Aged, Prospective Studies, Referral and Consultation, Risk Factors, Syncope, Statistics, Nonparametric, Evidence-Based Medicine
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