Syncope Time Frames for Adverse Events after Emergency Department Presentation : An Individual Patient Data Meta-Analysis
Furlan, Ludovico (Pronto Soccorso e Medicina d'Urgenza)
Trombetta, Lucia (Università degli Studi di Milano)
Casazza, Giovanni (Università degli Studi di Milano)
Dipaola, Franca (Humanitas University)
Furlan, Raffaello (Humanitas University)
Marta, Chiara (Pronto Soccorso e Medicina d'Urgenza)
Numeroso, Filippo (University Hospital of Parma (Parma, Itàlia))
Pérez-Rodón, Jordi (Hospital Universitari Vall d'Hebron)
Quinn, James V. (Stanford University)
Reed, Matthew J. (Royal Infirmary of Edinburgh)
Sheldon, Robert S. (University of Calgary)
Shen, Win-Kuang (Mayo Clinic Arizona (Phoenix, Estats Units d'Amèrica))
Sun, Benjamin C. (University of Pennsylvania)
Thiruganasambandamoorthy, Venkatesh (University of Ottawa)
Ungar, Andrea (Università degli Studi di Firenze)
Costantino, Giorgio (Università degli Studi di Milano)
Solbiati, Monica (Università degli Studi di Milano)
Universitat Autònoma de Barcelona

Data:	2021
Resum:	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. 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. 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. 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.
Drets:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Llengua:	Anglès
Document:	Article ; recerca ; Versió publicada
Matèria:	Adverse events ; Arrhythmia ; ECG monitoring ; Emergency department ; Individual patient data ; Meta-analysis ; Mortality ; Outcomes ; Syncope
Publicat a:	Medicina, Vol. 57 (november 2021) , ISSN 1648-9144

DOI: 10.3390/medicina57111235
PMID: 34833453

9 p, 646.7 KB

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