Role of emergency department observation units in the management of patients with unexplained syncope: a critical review and meta-analysis
Clinical and Experimental Emergency Medicine
;
(4): 201-207, 2017.
Artigo
em Inglês
| WPRIM
| ID: wpr-648820
ABSTRACT
This meta-analysis aimed to establish the role of standardized emergency department (ED) observation protocols in the management of syncopal patients as an alternative to ordinary admission. A systematic electronic literature search was performed to identify randomized controlled trials or observational studies evaluating syncopal patients managed in ED observation units. Data regarding mean length of stay, rate of etiological diagnosis, admission rate, and incidence of short-term serious outcomes were extracted. Six mostly single-center, small sized studies characterized by high heterogeneity, were included. A total of 458 patients were included with a balanced sex distribution (male 50.2%), a mean age of 60.1 years, and a considerable prevalence of heart disease (32.4%). Pooled analysis of the outcomes showed a mean stay of 28.2 hours, an etiological diagnosis rate of 67.3%, an admission rate of 18.5%, and a very low incidence of short-term serious outcomes (2.8%). Due to elevated diagnostic yield and low incidence of short-term adverse events, ED observation units-based management strategy seems ideal for patients with syncope. Nevertheless, further research is needed to identify criteria for selecting patients to be managed with this approach, define evaluation protocols, and confirm the safety of this strategy.
Texto completo:
DisponíveL
Índice:
WPRIM (Pacífico Ocidental)
Assunto principal:
Síncope
/
Características da População
/
Incidência
/
Prevalência
/
Distribuição por Sexo
/
Diagnóstico
/
Emergências
/
Serviço Hospitalar de Emergência
/
Cardiopatias
/
Tempo de Internação
Tipo de estudo:
Ensaio Clínico Controlado
/
Estudo diagnóstico
/
Guia de Prática Clínica
/
Estudo de incidência
/
Estudo observacional
/
Estudo de prevalência
/
Estudo prognóstico
/
Revisões Sistemáticas Avaliadas
Limite:
Humanos
Idioma:
Inglês
Revista:
Clinical and Experimental Emergency Medicine
Ano de publicação:
2017
Tipo de documento:
Artigo
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