Clinical course in older patients diagnosed with syncope treated in Spanish emergency departments: results from the Emergency Department and Elder Needs-17 study
Por:
García, RM, Piñera-Salmerón, P, Jacob, J, del Castillo, JG, Montero-Pérez, FJ, Alquézar-Arbé, A, García-Lamberechts, EJ, Aguiló, S, Fernández-Alonso, C, Burillo-Putze, G, Gil-Rodrigo, A, Llorens, P, Mota, MS, Chaib, FB, García, JP, Baena, SB, Giménez, DEM, Díez, MPL, Martín, MM, Romero, MR, Company, TB, Borrego, BV, Fernández, MC, Sánchez, CE, Muñoz, MA, Miró, O
Publicada:
1 ago 2024
Resumen:
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.
Filiaciones:
García, RM:
Hosp Comarcal Valle Pedroches, Serv Urgencias, Cordoba, Spain
Grp Trabajo Arritmias Sincope SEMES, Murcia, Spain
Piñera-Salmerón, P:
Hosp Univ Reina Sofia, Serv Urgencias, Ave Intendente Jorge Palacios 1, Murcia 30003, Spain
Jacob, J:
Univ Barcelona, IDIBELL, Hosp Univ Bellvitge, Serv Urgencias, Barcelona, Spain
del Castillo, JG:
Univ Complutense, IDISSC, Serv Urgencias, Hosp Clin San Carlos, Madrid, Spain
Montero-Pérez, FJ:
Hosp Univ Reina Sofia, Serv Urgencias, Cordoba, Spain
Alquézar-Arbé, A:
Hosp Santa Creu & Sant Pau, Serv Urgencias, Barcelona, Spain
García-Lamberechts, EJ:
Univ Complutense, IDISSC, Serv Urgencias, Hosp Clin San Carlos, Madrid, Spain
Aguiló, S:
Univ Barcelona, IDIBAPS, Hosp Clin, Area Urgencias, Barcelona, Spain
Fernández-Alonso, C:
Univ Complutense, IDISSC, Serv Urgencias, Hosp Clin San Carlos, Madrid, Spain
Burillo-Putze, G:
Hosp Univ Canarias, Serv Urgencias, Tenerife, Spain
Gil-Rodrigo, A:
Univ Miguel Hernandez, Unidad Estancia Corta & Hospitalizac Domicilio, Serv Urgencias,Hosp Gen Doctor Balmis, Inst Invest Sanitaria & Biomed Alicante ISABIAL, Alicante, Spain
Llorens, P:
Univ Miguel Hernandez, Unidad Estancia Corta & Hospitalizac Domicilio, Serv Urgencias,Hosp Gen Doctor Balmis, Inst Invest Sanitaria & Biomed Alicante ISABIAL, Alicante, Spain
Mota, MS:
Hosp Reg Malaga, Serv Urgencias, Malaga, Spain
Chaib, FB:
Hosp Santa Barbara, Serv Urgencias, Soria, Spain
García, JP:
Hosp Comarcal Valle Pedroches, Serv Urgencias, Cordoba, Spain
Grp Trabajo Arritmias Sincope SEMES, Murcia, Spain
Baena, SB:
Hosp Univ Reina Sofia, Serv Urgencias, Cordoba, Spain
Giménez, DEM:
Hosp Univ Gregorio Maranon, Serv Urgencias, Madrid, Spain
Díez, MPL:
Hosp Univ Burgos, Serv Urgencias, Burgos, Spain
Martín, MM:
Complejo Asistencial Univ Leon, Serv Urgencias, Leon, Spain
Romero, MR:
Hosp Univ Morales Meseguer, Serv Urgencias, Murcia, Spain
Company, TB:
Hosp Francecs Borja, Serv Urgencias, Valencia, Spain
Borrego, BV:
Hosp Univ Severo Ochoa, Serv Urgencias, Madrid, Spain
Fernández, MC:
Hosp Virgen Arrixaca, Serv Urgencias, Murcia, Spain
Sánchez, CE:
Hosp Univ Lorenzo Guirao, Serv Urgencias, Murcia, Spain
Muñoz, MA:
Hosp Josep Trueta, Serv Urgencias, Girona, Spain
Miró, O:
Univ Barcelona, IDIBAPS, Hosp Clin, Area Urgencias, Barcelona, Spain
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