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- W2087652998 abstract "Syncope represents 1-6% of total admissions to the hospital. Identification of high-risk patients (pts) at the ER is essential for avoiding unnecessary admissions. To retrospectively evaluate the ACEP recommendations for syncope admissions and the OESIL risk score for syncope stratification in pts with syncope admitted to the Internal Medicine Service. Two blinded investigators review all the charts and retrospectively applied the guidelines. ACEP recommendations were divided into level B (high sensitivity and specificity to detect cardiac syncope) and C (high sensitivity, low specificity). OESIL risk score was divided into 0-1 points (less than 1% of mortality risk) and 2-4 (more than 20% of mortality risk). We assumed that pts with an OESIL > 2 should be admitted due to high risk of cardiac mortality. Between June 2003-July 2004, 75 pts were admitted. Mean age was 68±14 years, 41% were female. Structural heart disease was present in 60% and ECG was abnormal in 25%. A diagnosis was achieved in 40 pts (54%), vasovagal syncope 22 (55%), cardiac 6 (15%), orthostatic hypotension 7 (18%), drug-induced 2 (5%) and neurologic 2 (5%). The average length of stay was 4.2±3.7 days. ACEP level B Sensitivity 100%, Specificity 81%, ACEP level C; Sensitivity 100%, Specificity 26%. The majority of syncope admissions to an Internal Medicine Service were low risk. ACEP level B recommendations had a good sensitivity identifying cardiac causes of syncope. However, ACEP guidelines overestimate cardiac causes leading to unnecessary admissions. Level C recommendations have poor specificity (26%) leading to unnecessary admissions. OESIL score identified 30% of pts with very low mortality that may have been unnecessarily admitted." @default.
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- W2087652998 date "2005-10-01" @default.
- W2087652998 modified "2023-10-18" @default.
- W2087652998 title "Application of the American College of Emergency Physicians (ACEP) Recommendations and a Risk Stratification System (OESIL) for Patients with Syncope Admitted in Internal Medicine Service" @default.
- W2087652998 doi "https://doi.org/10.1016/j.eupc.2005.08.027" @default.
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