Syncope in the emergency department of a large northern Italian hospital: incidence, efficacy of a short-stay observation ward and validation of the OESIL risk score

Emerg Med J. 2010 Sep;27(9):653-8. doi: 10.1136/emj.2009.077701. Epub 2010 Jun 1.

Abstract

Objective: Syncope causes 1-3% of all emergency department (ED) visits, a high percentage of hospitalisations and prolonged hospital stay; nevertheless, many cases remain unexplained.

Methods: This study analysed the incidence of syncope at the ED of the University Hospital of Parma in the first half of 2008; then a sample of 200 patients admitted later for syncope into the ED ward was studied, in order to evaluate the efficacy of a brief observation unit and to validate the Osservatorio Epidemiologico della Sincope nel Lazio (OESIL) risk score as a tool to identify cardiogenic syncopes.

Results and conclusions: As reported in the literature, syncope accounts for 2.3% of ED consultations and for 4.2% of total hospital admissions. A brief observation ward in the ED seems to have the necessary characteristics for managing most cases of syncope quickly (3.5 days). The final diagnosis was certain in 60%, suspected in 33% and unexplained in 7% of patients. The commonest forms of syncope were non-cardiogenic. Factors associated with cardiogenic syncope were previous syncopal events, lack of prodromal symptoms and a high OESIL risk score.

Publication types

  • Validation Study

MeSH terms

  • Diagnosis, Differential
  • Emergency Service, Hospital
  • Female
  • Hospitalization / statistics & numerical data
  • Hospitals, University
  • Humans
  • Incidence
  • Italy
  • Length of Stay
  • Male
  • Middle Aged
  • Retrospective Studies
  • Syncope / diagnosis*
  • Syncope / epidemiology
  • Syncope / etiology