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Multicenter Study Observational Study
Clinical course in older patients diagnosed with syncope treated in Spanish emergency departments: results from the Emergency Department and Elder Needs-17 study.
- Rocío Moyano García, Pascual Piñera-Salmerón, Javier Jacob, Juan González Del Castillo, FranciscoJavier Montero-Pérez, Aitor Alquézar-Arbé, Eric Jorge García-Lamberechts, Sira Aguiló, Cesáreo Fernández-Alonso, Guillermo Burillo-Putze, Adriana Gil-Rodrigo, Pere Llorens, Manuel Salido Mota, Fahd Beddar Chaib, Jorge Pedraza García, Sierra Bretones Baena, Dariela Edith Micheloud Giménez, María Pilar López Díez, Miguel Moreno Martín, María Rodríguez Romero, Teresa Benavent Company, Beatriz Valle Borrego, Marina Carrión Fernández, Carmen Escudero Sánchez, María Adroher Muñoz, Òscar Miró, and EDEN Research Group.
- Servicio de Urgencias, Hospital Comarcal Valle de los Pedroches, Pozoblanco, Córdoba. Grupo de Trabajo de Arritmias y Síncope de SEMES, España.
- Emergencias. 2024 Jun 1; 36 (4): 281289281-289.
ObjectiveTo study factors associated with hospitalization in an unselected population of patients aged 65 years or older treated for syncope in Spanish hospital emergency departments (EDs). To determine the prevalence of adverse events at 30 days in patients discharged home and the factors associated with such events.MethodsWe included all patients aged 65 years or older who were diagnosed with syncope during a single week in 52 Spanish EDs, recording patient clinical and ED case management data. We compared the findings between hospitalized patients and those discharged home, following the latter for 30 days. In discharged patients, we explored predictors of a composite adverse-event outcome (occurrence of any of the following: ED revisits, hospitalization related to the index visit, or any-cause death).ResultsA total of 477 patients with syncope were identified; 67 (14%) were admitted, and 5 (7.5%) died. The median (interquartile range) length of hospital stay was 6 days (3-11 days). Comorbidity increased the probability of hospitalization (odds ratio, 2.172; 95% CI, 1.013-4.655). Among the 410 patients (86%) discharged home from the ED, 9.2% experienced an adverse event within 30 days (ED revisits, 8.,1%; hospitalization, 2.2%; death, 1.5%). No factors were associated with the 30-day composite outcome.ConclusionsThe majority of patients aged 65 years or older are discharged home from EDs, and 30-day adverse events, while infrequent, are difficult to predict. Hospitalization was related to comorbidity and an absence of cognitive decline.
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