"Pulmonary Embolism Prevalence in Patients Hospitalized for Syncope". New England Journal of Medicine. 2016. DOI: 10.1056/NEJMoa1602172. PubMed
Links to original sources: Wiki Journal Post Full Journal Article
Contents 1 Clinical Question 2 Bottom Line 3 Major Points 4 Guidelines 5 Design 6 Population 6.1 Inclusion Criteria 6.2 Exclusion Criteria 6.3 Baseline Characteristics 7 Interventions 8 Outcomes 8.1 Primary Outcomes 9 Funding 10 Further Reading
What is the prevalence of pulmonary embolism in patients hospitalized for a first episode of syncope?
Pulmonary embolism was identified in nearly one out of every six patients hospitalized for a first episode of syncope.
Current guidelines do not emphasize deep exploration for pulmonary embolism (PE) in patients presenting with syncope. However, this study found that PE is relatively common in hospitalized patients following a syncope event. There was a high prevalence of approximately 17.3%.
Since this study, guidelines may pay more attention to evaluating for PE in patients who present with syncope.
Cross-sectional study conducted across 11 hospitals in Italy, examining patients older than 18 hospitalized for a first episode of syncope.
In total, 560 patients were included in the study with a mean age of 76 years.
Inclusion Criteria Patients older than 18 years, hospitalized for a first episode of syncope, with syncope defined as transient loss of consciousness with rapid onset, short duration, and spontaneous resolution.
Exclusion Criteria Patients with previous episodes of syncope, those on anticoagulation therapy, or who were pregnant.
Baseline Characteristics Elderly population with over 75% of participants aged 70 or older. Most patients had clinical evidence suggesting an explanation for syncope other than PE.
Patients had a systematic workup for PE based on the 2014 guidelines of the European Society of Cardiology using a combination of Wells score and d-dimer assay results. Further assessment included computed tomography or ventilation-perfusion lung scanning when indicated.
Primary Outcomes The primary outcome was the prevalence of pulmonary embolism diagnosed by imaging or autopsy in patients admitted to the hospital following an episode of syncope.
Supported by institutional research funding from the University of Padua.
The original publication in the New England Journal of Medicine, 2016, and the accompanying editorial and supplementary material may provide further insights into the study details and its implications for clinical practice.