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A Rational Evaluation of the Syncope Patient: Optimizing the Emergency Department Visit

Syncope accounts for up to 2% of emergency department visits and results in the hospitalization of 12–86% of patients. There is often a low diagnostic yield, with up to 50% of hospitalized patients being discharged with no clear diagnosis. We will outline a structured approach to the syncope patient...

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Detalles Bibliográficos
Autores principales: Hatoum, Tarek, Sheldon, Robert S.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8224075/
https://www.ncbi.nlm.nih.gov/pubmed/34064050
http://dx.doi.org/10.3390/medicina57060514
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author Hatoum, Tarek
Sheldon, Robert S.
author_facet Hatoum, Tarek
Sheldon, Robert S.
author_sort Hatoum, Tarek
collection PubMed
description Syncope accounts for up to 2% of emergency department visits and results in the hospitalization of 12–86% of patients. There is often a low diagnostic yield, with up to 50% of hospitalized patients being discharged with no clear diagnosis. We will outline a structured approach to the syncope patient in the emergency department, highlighting the evidence supporting the role of clinical judgement and the initial electrocardiogram (ECG) in making the preliminary diagnosis and in safely identifying the patients at low risk of short- and long-term adverse events or admitting the patient if likely to benefit from urgent intervention. Clinical decision tools and additional testing may aid in further stratifying patients and may guide disposition. While hospital admission does not seem to offer additional mortality benefit, the efficient utilization of outpatient testing may provide similar diagnostic yield, preventing unnecessary hospitalizations.
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spelling pubmed-82240752021-06-25 A Rational Evaluation of the Syncope Patient: Optimizing the Emergency Department Visit Hatoum, Tarek Sheldon, Robert S. Medicina (Kaunas) Review Syncope accounts for up to 2% of emergency department visits and results in the hospitalization of 12–86% of patients. There is often a low diagnostic yield, with up to 50% of hospitalized patients being discharged with no clear diagnosis. We will outline a structured approach to the syncope patient in the emergency department, highlighting the evidence supporting the role of clinical judgement and the initial electrocardiogram (ECG) in making the preliminary diagnosis and in safely identifying the patients at low risk of short- and long-term adverse events or admitting the patient if likely to benefit from urgent intervention. Clinical decision tools and additional testing may aid in further stratifying patients and may guide disposition. While hospital admission does not seem to offer additional mortality benefit, the efficient utilization of outpatient testing may provide similar diagnostic yield, preventing unnecessary hospitalizations. MDPI 2021-05-21 /pmc/articles/PMC8224075/ /pubmed/34064050 http://dx.doi.org/10.3390/medicina57060514 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Review
Hatoum, Tarek
Sheldon, Robert S.
A Rational Evaluation of the Syncope Patient: Optimizing the Emergency Department Visit
title A Rational Evaluation of the Syncope Patient: Optimizing the Emergency Department Visit
title_full A Rational Evaluation of the Syncope Patient: Optimizing the Emergency Department Visit
title_fullStr A Rational Evaluation of the Syncope Patient: Optimizing the Emergency Department Visit
title_full_unstemmed A Rational Evaluation of the Syncope Patient: Optimizing the Emergency Department Visit
title_short A Rational Evaluation of the Syncope Patient: Optimizing the Emergency Department Visit
title_sort rational evaluation of the syncope patient: optimizing the emergency department visit
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8224075/
https://www.ncbi.nlm.nih.gov/pubmed/34064050
http://dx.doi.org/10.3390/medicina57060514
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