Data/hora: 05/06/2024 07:28:43

Provedor de dados: | 56
País: | Brazil
Título: | Structural heart disease as the cause of syncope
Autores: | Guimarães,R.B.; Essebag,V.; Furlanetto,M.; Yanez,J.P.G.; Farina,M.G.; Garcia,D.; Almeida,E.D.; Stephan,L.; Lima,G.G.; Leiria,T.L.L.
Data: | 2018-01-01
Ano: | 2018
Palavras-chave: | Syncope; Hospitalization; Structural heart; Emergency.
Resumo: | We described the clinical evolution of patients with structural heart disease presenting at the emergency room with syncope. Patients were stratified according to their syncope etiology and available scores for syncope prognostication. Cox proportional hazard models were used to investigate the relationship between etiology of the syncope and event-free survival. Of the 82,678 emergency visits during the study period, 160 (0.16%) patients were there due to syncope, having a previous diagnosis of structural heart disease. During the median follow-up of 33.8±13.8 months, mean age at the qualifying syncope event was 68.3 years and 40.6% of patients were male. Syncope was vasovagal in 32%, cardiogenic in 57%, orthostatic hypotension in 6%, and of unknown causes in 5% of patients. The primary composite endpoint death, readmission, and emergency visit in 30 days was 39.4% in vasovagal syncope and 60.6% cardiogenic syncope (P&lt;0.001). Primary endpoint-free survival was lower for patients with cardiogenic syncope (HR=2.97, 95%CI=1.94-4.55; P&lt;0.001). The scores were analyzed for diagnostic performance with area under the curve (AUC) and did not help differentiate patients with an increased risk of adverse events. The differential diagnosis of syncope causes in patients with structural heart disease is important, because vasovagal and postural hypotension have better survival and less probability of emergency room or hospital readmission. The available scores are not reliable tools for prognosis in this specific patient population.
Tipo: | Info:eu-repo/semantics/article
Idioma: | Inglês
Identificador: | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0100-879X2018000400616
Editor: | Associação Brasileira de Divulgação Científica
Relação: | 10.1590/1414-431x20176989
Formato: | text/html
Fonte: | Brazilian Journal of Medical and Biological Research  v.51 n.4 2018
Fonte: | info:eu-repo/semantics/openAccess