Assuntos
Vesícula/diagnóstico , Vesícula/terapia , Infecções por Clostridium/diagnóstico , Infecções por Clostridium/terapia , Infecções dos Tecidos Moles/diagnóstico , Infecções dos Tecidos Moles/terapia , Idoso de 80 Anos ou mais , Antibacterianos/uso terapêutico , Braço , Vesícula/microbiologia , Infecções por Clostridium/microbiologia , Clostridium septicum/isolamento & purificação , Terapia Combinada , Desbridamento , Diabetes Mellitus Tipo 2 , Diagnóstico Diferencial , Hidratação , Humanos , Masculino , Infecções dos Tecidos Moles/microbiologiaRESUMO
OBJECTIVE: Syncope causes 1-3% of all emergency department (ED) visits, a high percentage of hospitalisations and prolonged hospital stay; nevertheless, many cases remain unexplained. METHODS: This study analysed the incidence of syncope at the ED of the University Hospital of Parma in the first half of 2008; then a sample of 200 patients admitted later for syncope into the ED ward was studied, in order to evaluate the efficacy of a brief observation unit and to validate the Osservatorio Epidemiologico della Sincope nel Lazio (OESIL) risk score as a tool to identify cardiogenic syncopes. RESULTS AND CONCLUSIONS: As reported in the literature, syncope accounts for 2.3% of ED consultations and for 4.2% of total hospital admissions. A brief observation ward in the ED seems to have the necessary characteristics for managing most cases of syncope quickly (3.5 days). The final diagnosis was certain in 60%, suspected in 33% and unexplained in 7% of patients. The commonest forms of syncope were non-cardiogenic. Factors associated with cardiogenic syncope were previous syncopal events, lack of prodromal symptoms and a high OESIL risk score.