1
40
3
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Text
A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text.
URL Address
<a href="http://doi.org/10.12788/jhm.3082" target="_blank" rel="noreferrer noopener">http://doi.org/10.12788/jhm.3082</a>
Pages
823–828
Issue
12
Volume
13
Dublin Core
The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.
Title
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Predictors of Clinically Significant Echocardiography Findings in Older Adults with Syncope: A Secondary Analysis.
Publisher
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Journal of hospital medicine
Date
A point or period of time associated with an event in the lifecycle of the resource
2018
2018-12
Creator
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Probst Marc A; Gibson Thomas A; Weiss Robert E; Yagapen Annick N; Malveau Susan E; Adler David H; Bastani Aveh; Baugh Christopher W; Caterino Jeffrey M; Clark Carol L; Diercks Deborah B; Hollander Judd E; Nicks Bret A; Nishijima Daniel K; Shah Manish N; Stiffler Kirk A; Storrow Alan B; Wilber Scott T; Sun Benjamin C
Description
An account of the resource
BACKGROUND: Syncope is a common reason for visiting the emergency department (ED) and is associated with significant healthcare resource utilization. OBJECTIVE: To develop a risk-stratification tool for clinically significant findings on echocardiography among older adults presenting to the ED with syncope or nearsyncope. DESIGN: Prospective, observational cohort study from April 2013 to September 2016. SETTING: Eleven EDs in the United States. PATIENTS: We enrolled adults (=60 years) who presented to the ED with syncope or near-syncope who underwent transthoracic echocardiography (TTE). MEASUREMENTS: The primary outcome was a clinically significant finding on TTE. Clinical, electrocardiogram, and laboratory variables were also collected. Multivariable logistic regression analysis was used to identify predictors of significant findings on echocardiography. RESULTS: A total of 3,686 patients were enrolled. Of these, 995 (27%) received echocardiography, and 215 (22%) had a significant finding on echocardiography. Regression analysis identified five predictors of significant finding: (1) history of congestive heart failure, (2) history of coronary artery disease, (3) abnormal electrocardiogram, (4) high-sensitivity troponin-T \textgreater14 pg/mL, and 5) N-terminal pro B-type natriuretic peptide \textgreater125 pg/mL. These five variables make up the ROMEO (Risk Of Major Echocardiography findings in Older adults with syncope) criteria. The sensitivity of a ROMEO score of zero for excluding significant findings on echocardiography was 99.5% (95% CI: 97.4%-99.9%) with a specificity of 15.4% (95% CI: 13.0%-18.1%). CONCLUSIONS: If validated, this risk-stratification tool could help clinicians determine which syncope patients are at very low risk of having clinically significant findings on echocardiography. REGISTRATION: ClinicalTrials.gov Identifier NCT01802398.
Identifier
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<a href="http://doi.org/10.12788/jhm.3082" target="_blank" rel="noreferrer noopener">10.12788/jhm.3082</a>
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Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
2018
Adler David H
Bastani Aveh
Baugh Christopher W
Caterino Jeffrey M
Clark Carol L
Department of Emergency Medicine
Diercks Deborah B
Gibson Thomas A
Hollander Judd E
Journal of hospital medicine
Malveau Susan E
NEOMED College of Medicine
Nicks Bret A
Nishijima Daniel K
Probst Marc A
Shah Manish N
Stiffler Kirk A
Storrow Alan B
Sun Benjamin C
Weiss Robert E
Wilber Scott T
Yagapen Annick N
-
Text
A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text.
URL Address
<a href="http://doi.org/10.1111/acem.13709" target="_blank" rel="noreferrer noopener">http://doi.org/10.1111/acem.13709</a>
Rights
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
Pages
528-538
Issue
5
Volume
26
Dublin Core
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Title
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Do High-sensitivity Troponin and Natriuretic Peptide Predict Death or Serious Cardiac Outcomes After Syncope?
Publisher
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Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
Date
A point or period of time associated with an event in the lifecycle of the resource
2019
2019-05
Creator
An entity primarily responsible for making the resource
Clark Carol L; Gibson Thomas A; Weiss Robert E; Yagapen Annick N; Malveau Susan E; Adler David H; Bastani Aveh; Baugh Christopher W; Caterino Jeffrey M; Diercks Deborah B; Hollander Judd E; Nicks Bret A; Nishijima Daniel K; Shah Manish N; Stiffler Kirk A; Storrow Alan B; Wilber Scott T; Sun Benjamin C
Description
An account of the resource
OBJECTIVES: An estimated 1.2 million annual emergency department (ED) visits for syncope/near syncope occur in the United States. Cardiac biomarkers are frequently obtained during the ED evaluation, but the prognostic value of index high-sensitivity troponin (hscTnT) and natriuretic peptide (NT-proBNP) are unclear. The objective of this study was to determine if hscTnT and NT-proBNP drawn in the ED are independently associated with 30-day death/serious cardiac outcomes in adult patients presenting with syncope. METHODS: A prespecified secondary analysis of a prospective, observational trial enrolling participants ≥ age 60 presenting with syncope, at 11 United States hospitals, was conducted between April 2013 and September 2016. Exclusions included seizure, stroke, transient ischemic attack, trauma, intoxication, hypoglycemia, persistent confusion, mechanical/electrical invention, prior enrollment, or predicted poor follow-up. Within 3 hours of consent, hscTnT and NT-proBNP were collected and later analyzed centrally using Roche Elecsys Gen 5 STAT and 2010 Cobas, respectively. Primary outcome was combined 30-day all-cause mortality and serious cardiac events. Adjusting for illness severity, using multivariate logistic regression analysis, variations between primary outcome and biomarkers were estimated, adjusting absolute risk associated with ranges of biomarkers using Bayesian Markov Chain Monte Carlo methods. RESULTS: The cohort included 3,392 patients; 367 (10.8%) experienced the primary outcome. Adjusted absolute risk for the primary outcome increased with hscTnT and NT-proBNP levels. HscTnT levels ≤ 5 ng/L were associated with a 4% (95% confidence interval [CI] = 3%-5%) outcome risk, and hscTnT > 50 ng/L, a 29% (95% CI = 26%-33%) risk. NT-proBNP levels ≤ 125 ng/L were associated with a 4% (95% CI = 4%-5%) risk, and NT-proBNP > 2,000 ng/L a 29% (95% CI = 25%-32%) risk. Likelihood ratios and predictive values demonstrated similar results. Sensitivity analyses excluding ED index serious outcomes demonstrated similar findings. CONCLUSIONS: hscTnT and NT-proBNP are independent predictors of 30-day death and serious outcomes in older ED patients presenting with syncope.
Identifier
An unambiguous reference to the resource within a given context
<a href="http://doi.org/10.1111/acem.13709" target="_blank" rel="noreferrer noopener">10.1111/acem.13709</a>
2019
Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
Adler David H
Bastani Aveh
Baugh Christopher W
Caterino Jeffrey M
Clark Carol L
Department of Emergency Medicine
Diercks Deborah B
Gibson Thomas A
Hollander Judd E
June 2019 Update
Malveau Susan E
NEOMED College of Medicine
Nicks Bret A
Nishijima Daniel K
Shah Manish N
Stiffler Kirk A
Storrow Alan B
Sun Benjamin C
Weiss Robert E
Wilber Scott T
Yagapen Annick N
-
Text
A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text.
URL Address
<a href="http://doi.org/10.1016/j.ajem.2018.07.043" target="_blank" rel="noreferrer noopener">http://doi.org/10.1016/j.ajem.2018.07.043</a>
Rights
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
Pages
810-816
Issue
5
Volume
37
Dublin Core
The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.
Title
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Variation in diagnostic testing for older patients with syncope in the emergency department
Publisher
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American Journal of Emergency Medicine
Date
A point or period of time associated with an event in the lifecycle of the resource
2019
2019-05
Subject
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Cost; Diagnostic testing; Emergency department; Near syncope; Syncope; Variation; Yield
Creator
An entity primarily responsible for making the resource
Su Erica; Nicks Bret A; Shah Manish N; Adler David H; Bastani Aveh; Caterino Jeffrey M; Clark Carol L; Diercks Deborah B; Hollander Judd E; Malveau Susan E; Nishijima Daniel K; Stiffler Kirk A; Storrow Alan B; Wilber Scott T; Yagapen Annick N; Weiss Robert E; Gibson Thomas A; Baugh Christopher W; Sun Benjamin C
Description
An account of the resource
Background Older adults presenting with syncope often undergo intensive diagnostic testing with unclear benefit. We determined the variation, frequency, yield, and costs of tests obtained to evaluate older persons with syncope.
Identifier
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<a href="http://doi.org/10.1016/j.ajem.2018.07.043" target="_blank" rel="noreferrer noopener">10.1016/j.ajem.2018.07.043</a>
2019
Adler David H
American Journal of Emergency Medicine
Bastani Aveh
Baugh Christopher W
Caterino Jeffrey M
Clark Carol L
Cost
Department of Emergency Medicine
diagnostic testing
Diercks Deborah B
Emergency department
Gibson Thomas A
Hollander Judd E
June 2019 Update
Malveau Susan E
Near syncope
NEOMED College of Medicine
Nicks Bret A
Nishijima Daniel K
Shah Manish N
Stiffler Kirk A
Storrow Alan B
Su Erica
Sun Benjamin C
Syncope
Variation
Weiss Robert E
Wilber Scott T
Yagapen Annick N
Yield