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Electrocardiogram and cardiac testing among patients in the emergency department with seizure versus syncope
OBJECTIVE: Cardiogenic syncope can present as a seizure. The distinction between seizure disorder and cardiogenic syncope can only be made if one considers the diagnosis. Our main objective was to identify whether patients presenting with a chief complaint (reason for visit) as seizure or syncope re...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
The Korean Society of Emergency Medicine
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6614053/ https://www.ncbi.nlm.nih.gov/pubmed/31261481 http://dx.doi.org/10.15441/ceem.18.003 |
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author | White, Jennifer L. Hollander, Judd E. Pines, Jesse M. Mullins, Peter M. Chang, Anna Marie |
author_facet | White, Jennifer L. Hollander, Judd E. Pines, Jesse M. Mullins, Peter M. Chang, Anna Marie |
author_sort | White, Jennifer L. |
collection | PubMed |
description | OBJECTIVE: Cardiogenic syncope can present as a seizure. The distinction between seizure disorder and cardiogenic syncope can only be made if one considers the diagnosis. Our main objective was to identify whether patients presenting with a chief complaint (reason for visit) as seizure or syncope received an electrocardiogram in the emergency department across all age groups. METHODS: We conducted a secondary analysis of data collected in the 2010 to 2014 National Hospital Ambulatory Medical Care Survey comparing patients presenting with a chief complaint of syncope versus seizure to determine likelihood of getting an evaluation for possible life threatening cardiovascular disease. The primary endpoint was receiving an electrocardiogram in the emergency department; secondary endpoint was receiving cardiac biomarkers. RESULTS: There was a total of 144,094 patient encounters. Of these visits, 1,553 had syncope and 1,470 had seizure (60.3% vs. 44.2% female, 19.9% vs. 29.0% non-white). After adjusting for age, sex, mode of arrival and insurance, patients with syncope were more likely to receive an electrocardiogram compared to patients with seizure (odds ratio, 10.86; 95% confidence interval [CI], 8.52 to 13.84). This was true across all age groups (0 to 18 years, 56% vs. 7.5%; 18 to 44 years, 60% vs. 27%; 45 to 64 years, 82% vs. 41%; ≥65 years, 85% vs. 68%; P<0.01 for all). Car- diac biomarkers were also obtained more frequently in adult patients with syncope patients (18 to 44 years, 17.5% vs. 10.5%; 45 to 64 years, 33.8% vs. 21.4%; ≥65 years, 47.1% vs. 32.3%; P<0.01 for all). CONCLUSION: Patients evaluated in the emergency department for syncope received an electrocar- diogram and cardiac biomarkers more frequently than those that had seizure. |
format | Online Article Text |
id | pubmed-6614053 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | The Korean Society of Emergency Medicine |
record_format | MEDLINE/PubMed |
spelling | pubmed-66140532019-07-12 Electrocardiogram and cardiac testing among patients in the emergency department with seizure versus syncope White, Jennifer L. Hollander, Judd E. Pines, Jesse M. Mullins, Peter M. Chang, Anna Marie Clin Exp Emerg Med Original Article OBJECTIVE: Cardiogenic syncope can present as a seizure. The distinction between seizure disorder and cardiogenic syncope can only be made if one considers the diagnosis. Our main objective was to identify whether patients presenting with a chief complaint (reason for visit) as seizure or syncope received an electrocardiogram in the emergency department across all age groups. METHODS: We conducted a secondary analysis of data collected in the 2010 to 2014 National Hospital Ambulatory Medical Care Survey comparing patients presenting with a chief complaint of syncope versus seizure to determine likelihood of getting an evaluation for possible life threatening cardiovascular disease. The primary endpoint was receiving an electrocardiogram in the emergency department; secondary endpoint was receiving cardiac biomarkers. RESULTS: There was a total of 144,094 patient encounters. Of these visits, 1,553 had syncope and 1,470 had seizure (60.3% vs. 44.2% female, 19.9% vs. 29.0% non-white). After adjusting for age, sex, mode of arrival and insurance, patients with syncope were more likely to receive an electrocardiogram compared to patients with seizure (odds ratio, 10.86; 95% confidence interval [CI], 8.52 to 13.84). This was true across all age groups (0 to 18 years, 56% vs. 7.5%; 18 to 44 years, 60% vs. 27%; 45 to 64 years, 82% vs. 41%; ≥65 years, 85% vs. 68%; P<0.01 for all). Car- diac biomarkers were also obtained more frequently in adult patients with syncope patients (18 to 44 years, 17.5% vs. 10.5%; 45 to 64 years, 33.8% vs. 21.4%; ≥65 years, 47.1% vs. 32.3%; P<0.01 for all). CONCLUSION: Patients evaluated in the emergency department for syncope received an electrocar- diogram and cardiac biomarkers more frequently than those that had seizure. The Korean Society of Emergency Medicine 2019-06-28 /pmc/articles/PMC6614053/ /pubmed/31261481 http://dx.doi.org/10.15441/ceem.18.003 Text en Copyright © 2019 The Korean Society of Emergency Medicine This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/). |
spellingShingle | Original Article White, Jennifer L. Hollander, Judd E. Pines, Jesse M. Mullins, Peter M. Chang, Anna Marie Electrocardiogram and cardiac testing among patients in the emergency department with seizure versus syncope |
title | Electrocardiogram and cardiac testing among patients in the emergency department with seizure versus syncope |
title_full | Electrocardiogram and cardiac testing among patients in the emergency department with seizure versus syncope |
title_fullStr | Electrocardiogram and cardiac testing among patients in the emergency department with seizure versus syncope |
title_full_unstemmed | Electrocardiogram and cardiac testing among patients in the emergency department with seizure versus syncope |
title_short | Electrocardiogram and cardiac testing among patients in the emergency department with seizure versus syncope |
title_sort | electrocardiogram and cardiac testing among patients in the emergency department with seizure versus syncope |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6614053/ https://www.ncbi.nlm.nih.gov/pubmed/31261481 http://dx.doi.org/10.15441/ceem.18.003 |
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