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Thursday, May 30, 2019

Hospitalization in Syncope

R.E.B.E.L.EM - By Anand Swaminathan - May 30, 2019
Article:  Probst MA et al. Clinical Benefit of Hospitalization for Older Adults with Unexplained Syncope: 
A Propensity-Matched Analysis. Ann Emerg Med 2019. PMID: 31080027
"Clinical Question: 
Does hospital admission of ED patients >60 years of age with syncope reduce the rate of serious adverse outcomes?
Authors Conclusions:
“In our propensity-matched sample of older adults with unexplained syncope, for those with clinical characteristics similar to that of the discharged cohort, hospitalization was not associated with improvement in 30-day serious adverse event rates.”
Our Conclusions:
In this propensity-matched sample of prospectively enrolled patients > 60 years of age with syncope or near-syncope, hospitalization was not associated with a decrease in serious adverse events.
Potential to Impact Current Practice: 
While a randomized controlled trial is needed, this information should be used by the clinician to tailor the decision for hospitalization versus discharge for the individual patient.
Bottom Line: 
Hospitalization for patients who are not deemed to be high-risk for a serious cause of syncope, though common in older patients, does not appear to reduce the risk of serious adverse events."