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Erschienen in: Irish Journal of Medical Science (1971 -) 4/2010

01.12.2010 | Original Article

Resource utilisation for syncope presenting to an acute hospital Emergency Department

verfasst von: F. McCarthy, S. De Bhladraithe, C. Rice, C. G. McMahon, U. Geary, P. K. Plunkett, P. Crean, R. Murphy, B. Foley, N. Mulvihill, R. A. Kenny, C. J. Cunningham

Erschienen in: Irish Journal of Medical Science (1971 -) | Ausgabe 4/2010

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Abstract

Background

Syncope is a common clinical problem accounting for up to 6% of hospital admissions. Little is known about resource utilisation for patients admitted for syncope management in Ireland.

Aim

To determine the utilisation of resources for patients admitted for syncope management.

Methods

Single centre observational case series of consecutive adult patients presenting to an acute hospital Emergency Department with syncope over a 5-month period.

Results

Two-hundred and fourteen of 18,898 patients (1.1%) had a syncopal episode, 110 (51.4%) of whom were admitted. Mean length of stay was 6.9 days. Sixty-four of these admissions were deemed unnecessary by retrospective review when compared to ESC guidelines. Eighty-five (77.3%) admitted patients had cardiac investigations and 56 (51%) had brain imaging performed.

Conclusions

Syncope places a large demand on overstretched hospital resources. Most cases can be managed safely as an outpatient and to facilitate this, hospitals should develop outpatient Syncope Management Units.
Literatur
1.
Zurück zum Zitat Kapoor WN (1990) Evaluation and outcome of patients with syncope. Medicine (Baltimore) 69(3):160–175 Kapoor WN (1990) Evaluation and outcome of patients with syncope. Medicine (Baltimore) 69(3):160–175
2.
Zurück zum Zitat Brignole M, Alboni P, Benditt DG et al (2004) Guidelines on management (diagnosis and treatment) of syncope—update 2004. Eur Heart J 25(22):2054–2072CrossRefPubMed Brignole M, Alboni P, Benditt DG et al (2004) Guidelines on management (diagnosis and treatment) of syncope—update 2004. Eur Heart J 25(22):2054–2072CrossRefPubMed
3.
Zurück zum Zitat Brignole M, Menozzi C, Bartoletti A et al (2006) A new management of syncope: prospective systematic guideline-based evaluation of patients referred urgently to general hospitals. Eur Heart J 27(1):76–82CrossRefPubMed Brignole M, Menozzi C, Bartoletti A et al (2006) A new management of syncope: prospective systematic guideline-based evaluation of patients referred urgently to general hospitals. Eur Heart J 27(1):76–82CrossRefPubMed
4.
Zurück zum Zitat Bartoletti A, Fabiani P, Adriani P et al (2006) Hospital admission of patients referred to the Emergency Department for syncope: a single-hospital prospective study based on the application of the European Society of Cardiology Guidelines on syncope. Eur Heart J 27(1):83–88CrossRefPubMed Bartoletti A, Fabiani P, Adriani P et al (2006) Hospital admission of patients referred to the Emergency Department for syncope: a single-hospital prospective study based on the application of the European Society of Cardiology Guidelines on syncope. Eur Heart J 27(1):83–88CrossRefPubMed
5.
Zurück zum Zitat Sun BC, Emond JA, Camargo CA Jr (2004) Characteristics and admission patterns of patients presenting with syncope to US emergency departments, 1992–2000. Acad Emerg Med 11(10):1029–1034PubMed Sun BC, Emond JA, Camargo CA Jr (2004) Characteristics and admission patterns of patients presenting with syncope to US emergency departments, 1992–2000. Acad Emerg Med 11(10):1029–1034PubMed
6.
Zurück zum Zitat Blanc JJ, L’Her C, Gosselin G, Cornily JC, Fatemi M (2005) Prospective evaluation of an educational programme for physicians involved in the management of syncope. Europace 7(4):400–406CrossRefPubMed Blanc JJ, L’Her C, Gosselin G, Cornily JC, Fatemi M (2005) Prospective evaluation of an educational programme for physicians involved in the management of syncope. Europace 7(4):400–406CrossRefPubMed
7.
Zurück zum Zitat Quinn JV, Stiell IG, McDermott DA, Sellers KL, Kohn MA, Wells GA (2004) Derivation of the San Francisco Syncope Rule to predict patients with short-term serious outcomes. Ann Emerg Med 43(2):224–232CrossRefPubMed Quinn JV, Stiell IG, McDermott DA, Sellers KL, Kohn MA, Wells GA (2004) Derivation of the San Francisco Syncope Rule to predict patients with short-term serious outcomes. Ann Emerg Med 43(2):224–232CrossRefPubMed
8.
Zurück zum Zitat Shen WK, Decker WW, Smars PA et al (2004) Syncope Evaluation in the Emergency Department Study (SEEDS): a multidisciplinary approach to syncope management. Circulation. 110(24):3636–3645CrossRefPubMed Shen WK, Decker WW, Smars PA et al (2004) Syncope Evaluation in the Emergency Department Study (SEEDS): a multidisciplinary approach to syncope management. Circulation. 110(24):3636–3645CrossRefPubMed
9.
Zurück zum Zitat Brignole M, Disertori M, Menozzi C et al (2003) Management of syncope referred urgently to general hospitals with and without syncope units. Europace. 5(3):293–298CrossRefPubMed Brignole M, Disertori M, Menozzi C et al (2003) Management of syncope referred urgently to general hospitals with and without syncope units. Europace. 5(3):293–298CrossRefPubMed
10.
Zurück zum Zitat Blanc JJ, L’Her C, Touiza A, Garo B, L’Her E, Mansourati J (2002) Prospective evaluation and outcome of patients admitted for syncope over a 1 year period. Eur Heart J 23(10):815–820CrossRefPubMed Blanc JJ, L’Her C, Touiza A, Garo B, L’Her E, Mansourati J (2002) Prospective evaluation and outcome of patients admitted for syncope over a 1 year period. Eur Heart J 23(10):815–820CrossRefPubMed
11.
Zurück zum Zitat Crane SD (2002) Risk stratification of patients with syncope in an accident and emergency department. Emerg Med J. 19(1):23–27CrossRefPubMed Crane SD (2002) Risk stratification of patients with syncope in an accident and emergency department. Emerg Med J. 19(1):23–27CrossRefPubMed
12.
Zurück zum Zitat Sarasin FP, Louis-Simonet M, Carballo D et al (2001) Prospective evaluation of patients with syncope: a population-based study. Am J Med 111(3):177–184CrossRefPubMed Sarasin FP, Louis-Simonet M, Carballo D et al (2001) Prospective evaluation of patients with syncope: a population-based study. Am J Med 111(3):177–184CrossRefPubMed
13.
Zurück zum Zitat Linzer M, Yang EH, Estes NA 3rd, Wang P, Vorperian VR, Kapoor WN (1997) Diagnosing syncope. Part 1: Value of history, physical examination, and electrocardiography. Clinical Efficacy Assessment Project of the American College of Physicians. Ann Intern Med 126(12):989–996PubMed Linzer M, Yang EH, Estes NA 3rd, Wang P, Vorperian VR, Kapoor WN (1997) Diagnosing syncope. Part 1: Value of history, physical examination, and electrocardiography. Clinical Efficacy Assessment Project of the American College of Physicians. Ann Intern Med 126(12):989–996PubMed
14.
Zurück zum Zitat Kapoor WN, Karpf M, Wieand S, Peterson JR, Levey GS (1983) A prospective evaluation and follow-up of patients with syncope. N Engl J Med 309(4):197–204CrossRefPubMed Kapoor WN, Karpf M, Wieand S, Peterson JR, Levey GS (1983) A prospective evaluation and follow-up of patients with syncope. N Engl J Med 309(4):197–204CrossRefPubMed
15.
Zurück zum Zitat Farwell DJ, Sulke AN (2004) Does the use of a syncope diagnostic protocol improve the investigation and management of syncope? Heart. 90(1):52–58CrossRefPubMed Farwell DJ, Sulke AN (2004) Does the use of a syncope diagnostic protocol improve the investigation and management of syncope? Heart. 90(1):52–58CrossRefPubMed
16.
Zurück zum Zitat Krahn AD, Klein GJ, Yee R, Manda V (1999) The high cost of syncope: cost implications of a new insertable loop recorder in the investigation of recurrent syncope. Am Heart J 137(5):870–877CrossRefPubMed Krahn AD, Klein GJ, Yee R, Manda V (1999) The high cost of syncope: cost implications of a new insertable loop recorder in the investigation of recurrent syncope. Am Heart J 137(5):870–877CrossRefPubMed
17.
Zurück zum Zitat American College of Emergency Physicians. (2001) Clinical policy: critical issues in the evaluation and management of patients presenting with syncope. Ann Emerg Med 37(6):771–776CrossRef American College of Emergency Physicians. (2001) Clinical policy: critical issues in the evaluation and management of patients presenting with syncope. Ann Emerg Med 37(6):771–776CrossRef
18.
Zurück zum Zitat McCarthy F, McMahon CG, Geary U, Plunkett PK, Kenny RA, Cunningham CJ, European Society of Cardiology (2009) Management of syncope in the Emergency Department: a single hospital observational case series based on the application of European Society of Cardiology Guidelines. Europace 11(2):216–224CrossRefPubMed McCarthy F, McMahon CG, Geary U, Plunkett PK, Kenny RA, Cunningham CJ, European Society of Cardiology (2009) Management of syncope in the Emergency Department: a single hospital observational case series based on the application of European Society of Cardiology Guidelines. Europace 11(2):216–224CrossRefPubMed
19.
Zurück zum Zitat Cotter PE, Timmons S, O’Connor M, Twomey C, O’Mahony D (2006) The financial implications of falls in older people for an acute hospital. Ir J Med Sci 175(2):11–13CrossRefPubMed Cotter PE, Timmons S, O’Connor M, Twomey C, O’Mahony D (2006) The financial implications of falls in older people for an acute hospital. Ir J Med Sci 175(2):11–13CrossRefPubMed
20.
Zurück zum Zitat Kenny RA, O’Shea D, Walker HF (2002) Age ageing. Impact of a dedicated syncope and falls facility for older adults on emergency beds. 31(4)272–275 Kenny RA, O’Shea D, Walker HF (2002) Age ageing. Impact of a dedicated syncope and falls facility for older adults on emergency beds. 31(4)272–275
Metadaten
Titel
Resource utilisation for syncope presenting to an acute hospital Emergency Department
verfasst von
F. McCarthy
S. De Bhladraithe
C. Rice
C. G. McMahon
U. Geary
P. K. Plunkett
P. Crean
R. Murphy
B. Foley
N. Mulvihill
R. A. Kenny
C. J. Cunningham
Publikationsdatum
01.12.2010
Verlag
Springer-Verlag
Erschienen in
Irish Journal of Medical Science (1971 -) / Ausgabe 4/2010
Print ISSN: 0021-1265
Elektronische ISSN: 1863-4362
DOI
https://doi.org/10.1007/s11845-010-0497-z

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