Patient characteristics and diagnostic tests associated with syncopal falls: A Southwestern surgical congress multicenter study - 08/12/22

Doi : 10.1016/j.amjsurg.2022.07.018

Janet S. Lee ^a,^b,^⁎ , Abid D. Khan ^c , Christopher M. Quinn ^b,^d , Kathryn Colborn ^b,^d , Deven C. Patel ^e , Galinos Barmparas ^e , Daniel R. Margulies ^e , Christine J. Waller ^f , Kara J. Kallies ^g , Alec J. Fitzsimmons ^g , Shanu N. Kothari ^h , Alexander R. Raines ⁱ , Heidi Mahnken ⁱ , Julie Dunn ^j , Linda Zier ^j , Robert C. McIntyre ^b , Shane Urban ^b , Julia R. Coleman ^b,^k , Eric M. Campion ^k , Clay C. Burlew ^k , Thomas J. Schroeppel ^a
^a Department of Trauma and Acute Care Surgery, UCHealth Memorial Hospital, Colorado Springs, CO, USA
^b Department of Surgery, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
^c Department of Surgery, Division of Trauma and Acute Care Surgery, University of Chicago, Chicago, IL, USA
^d Surgical Outcomes and Applied Research, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
^e Department of Surgery, Cedars-Sinai Medical Center, Los Angeles, CA, USA
^f Department of Surgery, Gundersen Health System, La Crosse, WI, USA
^g Department of Medical Research, Gundersen Health System, La Crosse, WI, USA
^h Department of General Surgery, Prisma Health, Greenville, SC, USA
ⁱ Department of Surgery, University of Oklahoma Health Science Center, Oklahoma City, OK, USA
^j Department of Trauma and Acute Care Surgery, UCHealth Medical Center of the Rockies, Loveland, CO, USA
^k Department of Surgery, Denver Health Medical Center, Denver, CO, USA

^∗Corresponding author. 1400 E Boulder St, Colorado Springs, CO, 80909, USA.1400 E Boulder StColorado SpringsCO80909USA

Abstract

Background

Patients suspected of syncope frequently undergo laboratory and imaging studies to determine the etiology of the syncope. Variability exists in these workups across institutions. The purpose of this study was to evaluate the utilization and diagnostic yield of these workups and the patient characteristics associated with syncopal falls.

Methods

A multi-institutional retrospective review was performed on adult patients admitted after a fall between 1/2017–12/2018. Syncopal falls were compared to non-syncopal falls.

Results

4478 patients were included. There were 795 (18%) patients with a syncopal fall. Electrocardiogram, troponin, echocardiogram, CT angiography (CTA), and carotid ultrasound were more frequently tested in syncope patients compared to non-syncope patients. Syncope patients had higher rates of positive telemetry/Holter monitoring, CTAs, and electroencephalograms.

Conclusion

Patients who sustain syncopal falls frequently undergo diagnostic testing without a higher yield to determine the etiology of syncope.

Le texte complet de cet article est disponible en PDF.

Highlights

•	Underlying cardiovascular disease increases the risk of syncopal fall.
•	Syncope patients were more likely to undergo diagnostic testing.
•	Syncope patients did not have a higher diagnostic yield to determine the etiology of syncope.
•	Selective syncope workup should be utilized based on comorbidities and clinical presentation.

Le texte complet de cet article est disponible en PDF.