Internal and emergency medicine
-
Comparative Study
Evaluation of the current prognostic role of cardiogenic syncope.
Prior studies about the prognosis of syncopal patients shows that the 1-year mortality is consistently higher in cardiogenic than in non-cardiogenic or unexplained syncope. After 10 years, other studies have raised several concerns about this circumstantial evidence, showing that the risk of death is predicted by only the underlying heart disease and not from the syncope itself. This is a prospective cohort study aimed to compare the prognosis of cardiogenic and non-cardiogenic syncope. ⋯ At 1 month and 1 year after discharge, we compared the incidence of syncopal recurrences, major procedures, cardiovascular events and death for any reason in patients with cardiogenic versus non-cardiogenic syncope. Cardiogenic syncope was associated with the presence of at least one adverse event at short and long term. Despite the significant advances in the treatment of cardiovascular diseases over the past decades, cardiogenic syncope continues to be associated with a significantly worse prognosis when compared with non-cardiogenic syncope.
-
We evaluated the effect of body mass index (BMI) on intubation success rates and complications during emergency airway management. We retrospectively analyzed an airway registry at an academic medical center. The primary outcomes were the incidence of difficult intubation and complication rates, stratified by BMI. ⋯ BMI was not predictive of post-intubation complications. Airway management in the morbidly obese differed when compared with lean patients, with less use of rapid sequence intubation and increased use of fiberoptic bronchoscopy in the former. During emergency airway management, difficult intubation is more common in obese patients, and morbidly obese patients are more commonly treated as potentially difficult airways.