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首页> 外文期刊>European Heart Journal - Case Reports >Is our initial evaluation of patients admitted for syncope guideline-directed and cost-effective?
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Is our initial evaluation of patients admitted for syncope guideline-directed and cost-effective?

机译：我们的初步评估是否为晕厥指导指导且具有成本效益的患者？

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Introduction Recent American College of Cardiology and European Society of Cardiology guidelines for syncope evaluation help distinguish high-cardiac risk patients from those with low-risk orthostatic and neurogenic syncope. Inpatient evaluation is recommended if at least one high-risk feature is present. Objective To assess guideline adherence and its impact on hospitalization in patients who presented with syncope before and after the introduction of guideline-based syncope protocol in the emergency department (ED). Methods All adult patients admitted to general medicine from the ED with the primary diagnosis of syncope in the months of October 2016 and October 2018 (before and after the introduction of syncope protocol in 2017). Electronic charts were retrospectively reviewed for high-risk cardiac features and orthostatic blood pressure measurement. Results Sixty patients were admitted for syncope in October 2016 (n = 32) and October 2018 (n = 28), out of which 33 (55%) were female and 47 (78.3%) were over age 50. Forty-five patients had at least one high-risk feature. Excluding one patient with an alternate diagnosis at discharge, 14 out of 60 patients (23.3%) admitted for syncope did not have any high-risk feature. Orthostatic blood pressure was measured in 3 patients (5%) in the ED and 27 patients (45%) later in the hospitalization. Six out of eight patients with implanted cardioverter-defibrillator or pacemaker had their devices interrogated. After the introduction of syncope protocol, there was an improvement in the proportion of high-risk patients admitted [68.7% (22/32) in October 2016 vs. 82.1% (23/28) in October 2018]. Conclusion Utilizing syncope protocol in the ED may improve guideline adherence, direct appropriate disposition, and reduce healthcare expenses.
机译：介绍近期美国心脏病学院和欧洲心脏病学会的晕厥评价指南有助于区分高患有低风险原位和神经源性晕厥的患者。如果存在至少一个高风险功能，建议使用住院性评估。目的探讨在急诊部门（ED）在引入指南的晕厥协议之前和后患者在患有晕厥的患者入院的准则遵守及其影响。方法对eded录取一般医学的所有成年患者，2016年10月和2018年10月（2017年在讨厌协定的概论前后）的晕厥初步诊断。电子图表回顾性地审查了高风险心脏特征和直向性血压测量。结果2016年10月（N = 32）和2018年10月（N = 28）达到晕厥（N = 28），其中33名（55％）是女性，47名（78.3％）超过50岁。45名患者至少一个高风险的功能。排除一名患者在排放的替代诊断中，60例患者中的14名（23.3％）达成晕厥没有任何高危功能。在ed和27名患者中，在3例患者（5％）中测量直向血压，在住院后的3例患者（45％）。八个患者中有六个植入的心脏除颤器或起搏器的患者询问。在讨厌议定书的引入后，高风险患者的比例有所改善[68.7％（22/32）2016年10月的82.1％（23/28）]。结论利用ED中的Syncope协议可以改善指南依从性，直接适当的处置，并降低医疗费用。

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