Document Detail


Predictors of short-term (seven-day) cardiac outcomes after emergency department visit for syncope.
MedLine Citation:
PMID:  20102895     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Syncope is a common reason for emergency department (ED) visits, and patients are often admitted to exclude syncope of cardiovascular origin. Population-based data on patterns and predictors of cardiac outcomes may improve decision-making. Our objective was to identify patterns and predictors of short-term cardiac outcomes in ED patients with syncope. Administrative data from an integrated health system of 11 Southern California EDs were used to identify cardiac outcomes after ED presentation for syncope from January 1, 2002, to December 31, 2005. Syncope and cause of death were identified by codes from the International Classification of Disease, Ninth Revision. Cardiac outcomes included cardiac death and hospitalization or procedure consistent with ischemic heart disease, valvular disease, or arrhythmia. Predictors of cardiac outcomes were identified through multivariate logistic regression. There were 35,330 adult subjects who accounted for 39,943 ED visits for syncope. Risk of cardiac outcome sharply decreased following the 7 days after syncope. A 7-day cardiac outcome occurred in 893 cases (3%). Positive predictors of 7-day cardiac outcomes included age > or =60 years, male gender, congestive heart failure, ischemic heart disease, cardiac arrhythmia, and valvular heart disease. Negative predictors included dementia, pacemaker, coronary revascularization, and cerebrovascular disease. There was an age-dependent relation between 7-day cardiac outcomes and arrhythmia and valvular disease, with younger patients (<60 years of age) having greater risk of an event compared to their same-age counterparts. In conclusion, ED decision-making should focus on risk of cardiac event in the first 7 days after syncope and special attention should be given to younger patients with cardiac co-morbidities.
Authors:
Gelareh Z Gabayan; Stephen F Derose; Steven M Asch; Vicki Y Chiu; Sungching C Glenn; Carol M Mangione; Benjamin C Sun
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, N.I.H., Extramural; Research Support, U.S. Gov't, Non-P.H.S.    
Journal Detail:
Title:  The American journal of cardiology     Volume:  105     ISSN:  1879-1913     ISO Abbreviation:  Am. J. Cardiol.     Publication Date:  2010 Jan 
Date Detail:
Created Date:  2010-01-27     Completed Date:  2010-03-04     Revised Date:  2014-09-05    
Medline Journal Info:
Nlm Unique ID:  0207277     Medline TA:  Am J Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  82-6     Citation Subset:  AIM; IM    
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Death, Sudden, Cardiac / epidemiology*,  etiology
Emergency Service, Hospital*
Female
Follow-Up Studies
Hospitalization / statistics & numerical data*
Humans
Incidence
Male
Middle Aged
Population Surveillance / methods*
Prognosis
Syncope / epidemiology*,  therapy
Time Factors
United States / epidemiology
Young Adult
Grant Support
ID/Acronym/Agency:
K12//PHS HHS; K12 AG001004/AG/NIA NIH HHS; K12 AG001004-10/AG/NIA NIH HHS; P30-AG028748/AG/NIA NIH HHS
Comments/Corrections

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