Wednesday, May 10, 2017

PE in syncope: PESIT update

Fist10EM - By Justin Morgenstern - May 9, 2017
"By now, everyone has (unfortunately) heard about the PESIT trial. Given the many commentaries in the FOAM community, we are all familiar with the many reasons that the widely quoted 1 in 6 figure probably does not apply to our patients. If you need a reminder, I summarize the paper as part of this post, or you can read a more elegant post by Rory Spiegel here. For me, the biggest issue was that PESIT never passed the sniff test. We see a ton of syncope patients. There are massive syncope databases. And nowhere have we seen massive numbers of patients returning with PE.
A research letter was just published yesterday in JAMA that gives us another take on the issue:
Verma AA, Masoom H, Rawal S, Guo Y, Razak F, for the GEMINI Investigators. Pulmonary Embolism and Deep Venous Thrombosis in Patients Hospitalized With Syncope: A Multicenter Cross-sectional Study in Toronto, Ontario, Canada. JAMA Intern Med. Published online May 08, 2017. doi:10.1001/jamainternmed.2017.1246..."