Summary

Clinical course in older patients diagnosed with syncope treated in Spanish emergency departments: results from the Emergency Department and Elder Needs-17 study

Rocío Moyano García1, Pascual Piñera-Salmerón2, Javier Jacob3, Juan González del Castillo4, Francisco Javier Montero-Pérez5, Aitor Alquézar-Arbé6, Eric Jorge García-Lamberechts4, Sira Aguiló7, Cesáreo Fernández-Alonso4, Guillermo Burillo-Putze8, Adriana Gil-Rodrigo9, Pere Llorens9, Manuel Salido Mota10, Fahd Beddar Chaib11, Jorge Pedraza García1, Sierra Bretones Baena5, Dariela Edith Micheloud Giménez12, María Pilar López Díez13, Miguel Moreno Martín14, María Rodríguez Romero15, Teresa Benavent Company16, Beatriz Valle Borrego17, Marina Carrión Fernández18, Carmen Escudero Sánchez19, María Adroher Muñoz20, Òscar Miró7; EDEN Research Group

Affiliation of the authors

1Servicio de Urgencias, Hospital Comarcal Valle de los Pedroches, Pozoblanco, Córdoba. Grupo de Trabajo de Arritmias y Síncope de SEMES, Spain. 2Servicio de Urgencias, Hospital Universitario Reina Sofía, Murcia, Spain. 3Servicio de Urgencias, Hospital Universitari de Bellvitge, Universitat de Barcelona, IDIBELL, L’Hospitalet de Llobregat, Barcelona, Spain. 4Servicio de Urgencias, Hospital Clínico San Carlos, IDISSC, Universidad Complutense, Madrid, Spain. 5Servicio de Urgencias, Hospital Universitario Reina Sofía, Córdoba, Spain. 6Servicio de Urgencias, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain. 7Área de Urgencias, Hospital Clínic, IDIBAPS, Universitat de Barcelona, Barcelona, Spain. 8Servicio de Urgencias, Hospital Universitario de Canarias, Tenerife, Spain. 9Servicio de Urgencias, Unidad de Estancia Corta y Hospitalización a Domicilio, Hospital General Doctor Balmis, Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL), Universidad Miguel Hernández, Alicante, Spain. 10Servicio de Urgencias, Regional de Málaga, Spain. 11Servicio de Urgencias, Hospital Santa Barbara, Soria, Spain. 12Servicio de Urgencias, Hospital Universitario Gregorio Marañón, Madrid, Spain. 13Servicio de Urgencias, Hospital Universitario de Burgos, Spain. 14Servicio de Urgencias, Complejo Asistencial Universitario de León, Spain. 15Servicio de Urgencias, Hospital Universitario Morales Meseguer, Murcia, Spain. 16Servicio de Urgencias, Hospital Francecs de Borja, Gandía, Valencia, Spain. 17Servicio de Urgencias, Hospital Universitario Severo Ochoa, Leganés, Madrid, Spain. 18Servicio de Urgencias, Hospital Virgen de la Arrixaca, Murcia, Spain. 19Servicio de Urgencias, Hospital Universitario Lorenzo Guirao, Cieza, Murcia, Spain. 20Servicio de Urgencias, Hospital Josep Trueta, Girona, Spain.

DOI

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Moyano García R, Piñera-Salmerón P, Jacob J, González del Castillo J, Montero-Pérez FJ, Alquézar-Arbé A, et al. Clinical course in older patients diagnosed with syncope treated in Spanish emergency departments: results from the Emergency Department and Elder Needs-17 study. Emergencias. 2024;36:281-9

Summary

Objectives.

To study factors associated with hospitalization in an unselected population of patients aged 65 years or older treated for syncope in Spanish hospital emergency departments (EDs). To determine the prevalence of adverse events at 30 days in patients discharged home and the factors associated with such events.

Methods.

We included all patients aged 65 years or older who were diagnosed with syncope during a single week in 52 Spanish EDs, recording patient clinical and ED case management data. We compared the findings between hospitalized patients and those discharged home, following the latter for 30 days. In discharged patients, we explored predictors of a composite adverse-event outcome (occurrence of any of the following: ED revisits, hospitalization related to the index visit, or any-cause death).

Results.

A total of 477 patients with syncope were identified; 67 (14%) were admitted, and 5 (7.5%) died. The median (interquartile range) length of hospital stay was 6 days (3-11 days). Comorbidity increased the probability of hospitalization (odds ratio, 2.172; 95% CI, 1.013-4.655). Among the 410 patients (86%) discharged home from the ED, 9.2% experienced an adverse event within 30 days (ED revisits, 8.,1%; hospitalization, 2.2%; death, 1.5%). No factors were associated with the 30-day composite outcome.
Conclusion. The majority of patients aged 65 years or older are discharged home from EDs, and 30-day adverse events, while infrequent, are difficult to predict. Hospitalization was related to comorbidity and an absence of cognitive decline.

 

 

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