Risk Stratification and the Outcome in Patients with Syncope Pre and Post Implementation of European Society Guidelines in Emergency Department in Ismailia Hospitals, Egypt

• Main Author: Adel Hamed Elbaih, Mohamed S Elsakaya, Bassant Sayed Abdallah, Hanan Mohamed Kamal
• Format: Article
• Language: English
• Published: Bulgarian Association of Young Surgeons 2020-02-01
• Series: International Journal of Surgery and Medicine
• Subjects: syncope; guidelines; fate
• Online Access: http://www.ejos.org/index.php?fulltxt=59374&fulltxtj=136&fulltxtp=136-1564568837.pdf

Introduction: one of the common clinical problem is a syncope in the emergency department (ED), accounting for 1- 6% of the hospital admissions and 0.5-3% of ED visits. Multiple studies revealed that no applied guidelines in evaluations for syncope result in low diagnostic yield and high costs when compared to evaluations that follow standardized guidelines protocol. Aim: to improve management processes and the outcome of syncope patients by implementation of European society guidelines (published in 2009) in ED. Methods: the study is Interventional study included 90 Patients for each group attending Emergency Department in Xs hospitals with syncope (loss of postural tone lead to transient loss of consciousness, which caused by diffuse cerebral ischemia , usually associated with spontaneous, rapid and complete recovery). With follow-up short outcome for 7 days and meets inclusion and exclusion criteria. Results: in pre-implementation of the guidelines group. 40% of the studied patients discharged, 60% admitted, 44.4% equally admitted at cardiology and neurology departments and the outcome 53.3% did not have any adverse events within 7 days follow up. While 73.3% of the studied patients post-implementation discharged, 26.7% admitted. 100% admitted at cardiology department and 73.3% did not have any adverse events. Conclusion: The number of appropriate discharges and admission higher in post- implementation group than in pre-implementation group. The dangerous complications in the appropriately discharged group was significantly lesser than in the appropriately admitted group.