Sistema de Salut de Catalunya
Institut Català de la Salut
[Furlan L, Marta C] Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Pronto Soccorso e Medicina d’Urgenza, 20122 Milan, Italy. [Trombetta L] Scuola di Specializzazione in Medicina Interna, Università degli Studi di Milano, 20122 Milan, Italy. [Casazza G] Dipartimento di Scienze Cliniche e di Comunità, Università degli Studi di Milano, 20122 Milan, Italy. [Dipaola F, Furlan R] Department of Biomedical Sciences, Humanitas University, Internal Medicine, Humanitas Clinical and Research Center-IRCCS, 20089 Rozzano, Italy. [Pérez-Rodon J] Unitat d’Arítmia, Servei de Cardiologia, Vall d’Hebron Hospital Universitari, Barcelona, Spain. Universitat Autònoma de Barcelona, Bellaterra, Spain
Vall d'Hebron Barcelona Hospital Campus
2022-05-16T12:16:27Z
2022-05-16T12:16:27Z
2021-11
Eventos adversos; Arritmia; Resultados
Adverse events; Arrhythmia; Outcomes
Esdeveniments adversos; Arítmia; Resultats
Background and Objectives: Knowledge of the incidence and time frames of the adverse events of patients presenting syncope at the ED is essential for developing effective management strategies. The aim of the present study was to perform a meta-analysis of the incidence and time frames of adverse events of syncope patients. Materials and Methods: We combined individual patients’ data from prospective observational studies including adult patients who presented syncope at the ED. We assessed the pooled rate of adverse events at 24 h, 72 h, 7–10 days, 1 month and 1 year after ED evaluation. Results: We included nine studies that enrolled 12,269 patients. The mean age varied between 53 and 73 years, with 42% to 57% females. The pooled rate of adverse events was 5.1% (95% CI 3.4% to 7.7%) at 24 h, 7.0% (95% CI 4.9% to 9.9%) at 72 h, 8.4% (95% CI 6.2% to 11.3%) at 7–10 days, 10.3% (95% CI 7.8% to 13.3%) at 1 month and 21.3% (95% CI 15.8% to 28.0%) at 1 year. The pooled death rate was 0.2% (95% CI 0.1% to 0.5%) at 24 h, 0.3% (95% CI 0.1% to 0.7%) at 72 h, 0.5% (95% CI 0.3% to 0.9%) at 7–10 days, 1% (95% CI 0.6% to 1.7%) at 1 month and 5.9% (95% CI 4.5% to 7.7%) at 1 year. The most common adverse event was arrhythmia, for which its rate was 3.1% (95% CI 2.0% to 4.9%) at 24 h, 4.8% (95% CI 3.5% to 6.7%) at 72 h, 5.8% (95% CI 4.2% to 7.9%) at 7–10 days, 6.9% (95% CI 5.3% to 9.1%) at 1 month and 9.9% (95% CI 5.5% to 17) at 1 year. Ventricular arrhythmia was rare. Conclusions: The risk of death or life-threatening adverse event is rare in patients presenting syncope at the ED. The most common adverse events are brady and supraventricular arrhythmias, which occur during the first 3 days. Prolonged ECG monitoring in the ED in a short stay unit with ECG monitoring facilities may, therefore, be beneficial.
This research received no external funding.
Article
Published version
English
Síncope (Patologia); Arrítmia; Urgències mèdiques; DISEASES::Nervous System Diseases::Neurologic Manifestations::Neurobehavioral Manifestations::Consciousness Disorders::Unconsciousness::Syncope; DISEASES::Cardiovascular Diseases::Heart Diseases::Arrhythmias, Cardiac; HEALTH CARE::Health Care Facilities, Manpower, and Services::Health Facilities::Health Facility Administration::Hospital Administration::Hospital Departments::Emergency Service, Hospital; ENFERMEDADES::enfermedades del sistema nervioso::manifestaciones neurológicas::manifestaciones neuroconductuales::trastornos de la conciencia::inconsciencia::síncope; ENFERMEDADES::enfermedades cardiovasculares::enfermedades cardíacas::arritmias cardíacas; ATENCIÓN DE SALUD::instalaciones, servicios y personal de asistencia sanitaria::centros sanitarios::administración de establecimientos sanitarios::administración hospitalaria::departamentos hospitalarios::servicio hospitalario de urgencias
MDPI
Medicina;57(11)
https://doi.org/10.3390/medicina57111235
Attribution 4.0 International
http://creativecommons.org/licenses/by/4.0/
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