1
40
11
-
Text
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URL Address
<a href="http://doi.org/10.1016/j.annemergmed.2019.03.031" target="_blank" rel="noreferrer noopener">http://doi.org/10.1016/j.annemergmed.2019.03.031</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).
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Title
A name given to the resource
Clinical Benefit of Hospitalization for Older Adults With Unexplained Syncope: A Propensity-Matched Analysis
Publisher
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Annals of 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
Probst Marc A; Su Erica; 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
STUDY OBJECTIVE: Many adults with syncope are hospitalized solely for observation and testing. We seek to determine whether hospitalization versus outpatient management for older adults with unexplained syncope is associated with a reduction in postdisposition serious adverse events at 30 days. METHODS: We performed a propensity score analysis using data from a prospective, observational study of older adults with unexplained syncope or near syncope who presented to 11 emergency departments (EDs) in the United States. We enrolled adults (≥60 years) who presented with syncope or near syncope. We excluded patients with a serious diagnosis identified in the ED. Clinical and laboratory data were collected on all patients. The primary outcome was rate of post-ED serious adverse events at 30 days. RESULTS: We enrolled 2,492 older adults with syncope and no serious ED diagnosis from April 2013 to September 2016. Mean age was 73 years (SD 8.9 years), and 51% were women. The incidence of serious adverse events within 30 days after the index visit was 7.4% for hospitalized patients and 3.19% for discharged patients, representing an unadjusted difference of 4.2% (95% confidence interval 2.38% to 6.02%). After propensity score matching on risk of hospitalization, there was no statistically significant difference in serious adverse events at 30 days between the hospitalized group (4.89%) and the discharged group (2.82%) (risk difference 2.07%; 95% confidence interval -0.24% to 4.38%). CONCLUSION: 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.
Identifier
An unambiguous reference to the resource within a given context
<a href="http://doi.org/10.1016/j.annemergmed.2019.03.031" target="_blank" rel="noreferrer noopener">10.1016/j.annemergmed.2019.03.031</a>
2019
Adler David H
Annals of emergency medicine
Bastani Aveh
Baugh Christopher W
Caterino Jeffrey M
Clark Carol L
Department of Emergency Medicine
Diercks Deborah B
Hollander Judd E
June 2019 Update
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
Su Erica
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.annemergmed.2018.10.032" target="_blank" rel="noreferrer noopener">http://doi.org/10.1016/j.annemergmed.2018.10.032</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).
Pages
274-280
Issue
3
Volume
73
Dublin Core
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Title
A name given to the resource
Comparison of 30-Day Serious Adverse Clinical Events for Elderly Patients Presenting to the Emergency Department With Near-Syncope Versus Syncope.
Publisher
An entity responsible for making the resource available
Annals of emergency medicine
Date
A point or period of time associated with an event in the lifecycle of the resource
2019
2019-03
Creator
An entity primarily responsible for making the resource
Bastani Aveh; Su Erica; Adler David H; Baugh Christopher; Caterino Jeffrey M; Clark Carol L; Diercks Deborah B; Hollander Judd E; Malveau Susan E; Nicks Bret A; Nishijima Daniel K; Shah Manish N; Stiffler Kirk A; Storrow Alan B; Wilber Scott T; Yagapen Annick N; Weiss Robert E; Sun Benjamin C
Description
An account of the resource
STUDY OBJECTIVE: Controversy remains in regard to the risk of adverse events for patients presenting with syncope compared with near-syncope. The purpose of our study is to describe the difference in outcomes between these groups in a large multicenter cohort of older emergency department (ED) patients. METHODS: From April 28, 2013, to September 21, 2016, we conducted a prospective, observational study across 11 EDs in adults (>/=60 years) with syncope or near-syncope. A standardized data extraction tool was used to collect information during their index visit and at 30-day follow-up. Our primary outcome was the incidence of
Identifier
An unambiguous reference to the resource within a given context
<a href="http://doi.org/10.1016/j.annemergmed.2018.10.032" target="_blank" rel="noreferrer noopener">10.1016/j.annemergmed.2018.10.032</a>
2019
Adler David H
Annals of emergency medicine
Bastani Aveh
Baugh Christopher
Caterino Jeffrey M
Clark Carol L
Department of Emergency Medicine
Diercks Deborah B
Hollander Judd E
Malveau Susan E
NEOMED College of Medicine
Nicks Bret A
Nishijima Daniel K
Shah Manish N
Stiffler Kirk A
Storrow Alan B
Su Erica
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
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
A name given to the resource
Do High-sensitivity Troponin and Natriuretic Peptide Predict Death or Serious Cardiac Outcomes After Syncope?
Publisher
An entity responsible for making the resource available
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/10.1111/acem.13906" target="_blank" rel="noreferrer noopener">http://doi.org/10.1111/acem.13906</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).
ISSN
1553-2712
Search for Full-text
Locate full-text within NEOMED Library's e-journal collections
<a href="http://ezproxy.neomed.idm.oclc.org/login?url=http://doi.org/10.1111/acem.13906" target="_blank" rel="noreferrer noopener">NEOMED Full-text Holding (if available) - Proxy DOI: 10.1111/acem.13906</a>
<p>Users with a NEOMED Library login can search for full-text journal articles at the following url: <a href="https://libraryguides.neomed.edu/home">https://libraryguides.neomed.edu/home</a></p>
Update Year & Number
January 2020 Update
NEOMED College
NEOMED College of Medicine
NEOMED Department
Department of Emergency Medicine
Affiliated Hospital
Summa Health Akron
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
A name given to the resource
Frequency of Abnormal and Critical Lab Results in Older Patients Presenting to the Emergency Department with Syncope
Publisher
An entity responsible for making the resource available
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
2019-12-14
Creator
An entity primarily responsible for making the resource
Moore Andrew B; Su Erica; 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
Syncope is a common and costly chief complaint among patients presenting to the emergency department (ED), accounting for 740,000 ED visits annually with an estimated annual cost of $2.4 billion per year in the United States.1,2 Syncope presents a diagnostic dilemma for clinicians in the ED since differentiating serious and benign causes of syncope can be challenging, particularly in the older adult. Routine laboratory testing with complete blood count (CBC) and basic metabolic panel (BMP) is commonly ordered for patients presenting to the ED with syncope.
Identifier
An unambiguous reference to the resource within a given context
<a href="http://doi.org/10.1111/acem.13906" target="_blank" rel="noreferrer noopener">10.1111/acem.13906</a>
PMID: 31837233
Format
The file format, physical medium, or dimensions of the resource
Journal Article
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
Hollander Judd E
January 2020 Update
Journal Article
Malveau Susan E
Moore Andrew B
NEOMED College of Medicine
Nicks Bret A
Nishijima Daniel K
Shah Manish N
Stiffler Kirk A
Storrow Alan B
Su Erica
Summa Health Akron
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.13414" target="_blank" rel="noreferrer noopener">http://doi.org/10.1111/acem.13414</a>
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
A name given to the resource
Outcomes of Patients With Syncope and Suspected Dementia.
Publisher
An entity responsible for making the resource available
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
2018
2018-03
Subject
The topic of the resource
80 and Over; Aged; Dementia – Diagnosis – In Old Age; Dementia – Risk Factors; Dementia – Therapy; Emergency; Human; Iatrogenic Disease; Inpatients; Interviews; Length of Stay; Middle Age; Office Visits; Outcome Assessment; Outcomes (Health Care); Patient Assessment; Patient Discharge; Physicians; Prospective Studies; Surveys; Syncope – Diagnosis; Syncope – In Old Age; Syncope – Mortality
Creator
An entity primarily responsible for making the resource
Holden Timothy R; Shah Manish N; Gibson Tommy 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; Stiffler Kirk A; Storrow Alan B; Wilber Scott T; Sun Benjamin C
Description
An account of the resource
OBJECTIVES: Syncope and near-syncope are common in patients with dementia and a leading cause of emergency department (ED) evaluation and subsequent hospitalization. The objective of this study was to describe the clinical trajectory and short-term outcomes of patients who presented to the ED with syncope or near-syncope and were assessed by their ED provider to have dementia. METHODS: This multisite prospective cohort study included patients 60 years of age or older who presented to the ED with syncope or near-syncope between 2013 and 2016. We analyzed a subcohort of 279 patients who were identified by the treating ED provider to have baseline dementia. We collected comprehensive patient-level, utilization, and outcomes data through interviews, provider surveys, and chart abstraction. Outcome measures included serious conditions related to syncope and death. RESULTS: Overall, 221 patients (79%) were hospitalized with a median length of stay of 2.1 days. A total of 46 patients (16%) were diagnosed with a serious condition in the ED. Of the 179 hospitalized patients who did not have a serious condition identified in the ED, 14 (7.8%) were subsequently diagnosed with a serious condition during the hospitalization, and an additional 12 patients (6.7%) were diagnosed postdischarge within 30 days of the index ED visit. There were seven deaths (2.5%) overall, none of which were cardiac-related. No patients who were discharged from the ED died or had a serious condition in the subsequent 30 days. CONCLUSIONS: Patients with perceived dementia who presented to the ED with syncope or near-syncope were frequently hospitalized. The diagnosis of a serious condition was uncommon if not identified during the initial ED assessment. Given the known iatrogenic risks of hospitalization for patients with dementia, future investigation of the impact of goals of care discussions on reducing potentially preventable, futile, or unwanted hospitalizations while improving goal-concordant care is warranted.
Identifier
An unambiguous reference to the resource within a given context
<a href="http://doi.org/10.1111/acem.13414" target="_blank" rel="noreferrer noopener">10.1111/acem.13414</a>
Rights
Information about rights held in and over the resource
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
80 and over
Academic emergency medicine : official journal of the Society for Academic Emergency Medicine
Adler David H
Aged
Bastani Aveh
Baugh Christopher W
Caterino Jeffrey M
Clark Carol L
Dementia – Diagnosis – In Old Age
Dementia – Risk Factors
Dementia – Therapy
Department of Emergency Medicine
Diercks Deborah B
Emergency
Gibson Tommy A
Holden Timothy R
Hollander Judd E
Human
Iatrogenic Disease
Inpatients
interviews
Length of Stay
Malveau Susan E
Middle Age
NEOMED College of Medicine
Nicks Bret A
Nishijima Daniel K
Office Visits
Outcome Assessment
Outcomes (Health Care)
Patient Assessment
Patient Discharge
Physicians
Prospective Studies
Shah Manish N
Stiffler Kirk A
Storrow Alan B
Sun Benjamin C
Surveys
Syncope – Diagnosis
Syncope – In Old Age
Syncope – Mortality
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/10.12788/jhm.3082" target="_blank" rel="noreferrer noopener">http://doi.org/10.12788/jhm.3082</a>
Pages
823–828
Issue
12
Volume
13
Dublin Core
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Title
A name given to the resource
Predictors of Clinically Significant Echocardiography Findings in Older Adults with Syncope: A Secondary Analysis.
Publisher
An entity responsible for making the resource available
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
An entity primarily responsible for making the resource
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
An unambiguous reference to the resource within a given context
<a href="http://doi.org/10.12788/jhm.3082" target="_blank" rel="noreferrer noopener">10.12788/jhm.3082</a>
Rights
Information about rights held in and over the resource
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/10.1016/j.ajem.2018.08.004" target="_blank" rel="noreferrer noopener">http://doi.org/10.1016/j.ajem.2018.08.004</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
869-872
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
A name given to the resource
Recurrent syncope is not an independent risk predictor for future syncopal events or adverse outcomes
Publisher
An entity responsible for making the resource available
The 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
Creator
An entity primarily responsible for making the resource
Chang Anna Marie; Hollander Judd E; Su Erica; 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; 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
Almost 20% of patients with syncope will experience another event. It is unknown whether recurrent syncope is a marker for a higher or lower risk etiology of syncope. The goal of this study is to determine whether older adults with recurrent syncope have a higher likelihood of 30-day serious clinical events than patients experiencing their first episode. METHODS: This study is a pre-specified secondary analysis of a multicenter prospective, observational study conducted at 11 emergency departments in the US. Adults 60 years or older who presented with syncope or near syncope were enrolled. The primary outcome was occurrence of 30-day serious outcome. The secondary outcome was 30-day serious cardiac arrhythmia. In multivariate analysis, we assessed whether prior syncope was an independent predictor of 30-day serious events. RESULTS: The study cohort included 3580 patients: 1281 (35.8%) had prior syncope and 2299 (64.2%) were presenting with first episode of syncope. 498 (13.9%) patients had 1 prior episode while 771 (21.5%) had >1 prior episode. Those with recurrent syncope were more likely to have congestive heart failure, coronary artery disease, previous diagnosis of arrhythmia, and an abnormal ECG. Overall, 657 (18.4%) of the cohort had a serious outcome by 30 days after index ED visit. In multivariate analysis, we found no significant difference in risk of events (adjusted odds ratio 1.09; 95% confidence interval 0.90-1.31; p = 0.387). CONCLUSION: In older adults with syncope, a prior history of syncope within the year does not increase the risk for serious 30-day events.
Identifier
An unambiguous reference to the resource within a given context
<a href="http://doi.org/10.1016/j.ajem.2018.08.004" target="_blank" rel="noreferrer noopener">10.1016/j.ajem.2018.08.004</a>
2019
Adler David H
Bastani Aveh
Baugh Christopher W
Caterino Jeffrey M
Chang Anna Marie
Clark Carol L
Department of Emergency Medicine
Diercks Deborah B
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
Su Erica
Sun Benjamin C
The American journal of emergency medicine
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.2018.08.004" target="_blank" rel="noreferrer noopener">http://doi.org/10.1016/j.ajem.2018.08.004</a>
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
A name given to the resource
Recurrent syncope is not an independent risk predictor for future syncopal events or adverse outcomes.
Publisher
An entity responsible for making the resource available
The American journal of emergency medicine
Date
A point or period of time associated with an event in the lifecycle of the resource
2018
2018-08
Creator
An entity primarily responsible for making the resource
Chang Anna Marie; Hollander Judd E; Su Erica; 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; 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
Almost 20% of patients with syncope will experience another event. It is unknown whether recurrent syncope is a marker for a higher or lower risk etiology of syncope. The goal of this study is to determine whether older adults with recurrent syncope have a higher likelihood of 30-day serious clinical events than patients experiencing their first episode. METHODS: This study is a pre-specified secondary analysis of a multicenter prospective, observational study conducted at 11 emergency departments in the US. Adults 60years or older who presented with syncope or near syncope were enrolled. The primary outcome was occurrence of
Identifier
An unambiguous reference to the resource within a given context
<a href="http://doi.org/10.1016/j.ajem.2018.08.004" target="_blank" rel="noreferrer noopener">10.1016/j.ajem.2018.08.004</a>
Rights
Information about rights held in and over the resource
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
Chang Anna Marie
Clark Carol L
Department of Emergency Medicine
Diercks Deborah B
Hollander Judd E
Malveau Susan E
NEOMED College of Medicine
Nicks Bret A
Nishijima Daniel K
Shah Manish N
Stiffler Kirk A
Storrow Alan B
Su Erica
Sun Benjamin C
The American journal of emergency medicine
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.annemergmed.2019.08.429" target="_blank" rel="noreferrer noopener">http://doi.org/10.1016/j.annemergmed.2019.08.429</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).
ISSN
1097-6760
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<a href="http://ezproxy.neomed.idm.oclc.org/login?url=http://doi.org/10.1016/j.annemergmed.2019.08.429" target="_blank" rel="noreferrer noopener">NEOMED Full-text Holding (if available) - Proxy DOI: 10.1016/j.annemergmed.2019.08.429</a>
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Title
A name given to the resource
Risk Stratification of Older Adults Who Present to the Emergency Department With Syncope: The FAINT Score
Publisher
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Annals Of Emergency Medicine
Date
A point or period of time associated with an event in the lifecycle of the resource
2019
2019-10-23
Creator
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Probst Marc A; Gibson Thomas; 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
STUDY OBJECTIVE: Older adults with syncope are commonly treated in the emergency department (ED). We seek to derive a novel risk-stratification tool to predict 30-day serious cardiac outcomes. METHODS: We performed a prospective, observational study of older adults (≥60 years) with unexplained syncope or near syncope who presented to 11 EDs in the United States. Patients with a serious diagnosis identified in the ED were excluded. We collected clinical and laboratory data on all patients. Our primary outcome was 30-day all-cause mortality or serious cardiac outcome. RESULTS: We enrolled 3,177 older adults with unexplained syncope or near syncope between April 2013 and September 2016. Mean age was 73 years (SD 9.0 years). The incidence of the primary outcome was 5.7% (95% confidence interval [CI] 4.9% to 6.5%). Using Bayesian logistic regression, we derived the FAINT score: history of heart failure, history of cardiac arrhythmia, initial abnormal ECG result, elevated pro B-type natriuretic peptide, and elevated high-sensitivity troponin T. A FAINT score of 0 versus greater than or equal to 1 had sensitivity of 96.7% (95% CI 92.9% to 98.8%) and specificity 22.2% (95% CI 20.7% to 23.8%), respectively. The FAINT score tended to be more accurate than unstructured physician judgment: area under the curve 0.704 (95% CI 0.669 to 0.739) versus 0.630 (95% CI 0.589 to 0.670). CONCLUSION: Among older adults with syncope or near syncope of potential cardiac cause, a FAINT score of zero had a reasonably high sensitivity for excluding death and serious cardiac outcomes at 30 days. If externally validated, this tool could improve resource use for this common condition.
Identifier
An unambiguous reference to the resource within a given context
<a href="http://doi.org/10.1016/j.annemergmed.2019.08.429" target="_blank" rel="noreferrer noopener">10.1016/j.annemergmed.2019.08.429</a>
PMID: 31668571
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The file format, physical medium, or dimensions of the resource
Journal Article
2019
Adler David H
Annals of emergency medicine
Bastani Aveh
Baugh Christopher W
Caterino Jeffrey M
Clark Carol L
Department of Emergency Medicine
Diercks Deborah B
Gibson Thomas
Hollander Judd E
Journal Article
Malveau Susan E
NEOMED College of Medicine
Nicks Bret A
Nishijima Daniel K
November 2019 Update
Probst Marc A
Shah Manish N
Stiffler Kirk A
Storrow Alan B
Summa Health System Akron City Hospital
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.jemermed.2020.02.020" target="_blank" rel="noreferrer noopener">http://doi.org/10.1016/j.jemermed.2020.02.020</a>
ISSN
0736-4679 0736-4679
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<a href="http://neomed.idm.oclc.org/login?url=http://doi.org/10.1016/j.jemermed.2020.02.020" target="_blank" rel="noreferrer noopener">NEOMED Full-text Holding (if available) - Proxy DOI: 10.1016/j.jemermed.2020.02.020</a>
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Update Year & Number
June 2020 Update II
NEOMED College
NEOMED College of Medicine
NEOMED Department
Department of Emergency Medicine
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
A name given to the resource
The Accuracy of Interqual Criteria in Determining the Observation versus Inpatient Status in Older Adults with Syncope.
Publisher
An entity responsible for making the resource available
The Journal of emergency medicine
Date
A point or period of time associated with an event in the lifecycle of the resource
2020
2020-04-11
Subject
The topic of the resource
case management; geriatrics; InterQual; syncope
Creator
An entity primarily responsible for making the resource
Chang Anna Marie; Hollander Judd E; Su Erica; 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; 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: McKesson's InterQual criteria are widely used in hospitals to determine if patients should be classified as observation or inpatient status, but the accuracy of the criteria is unknown. OBJECTIVE: We sought to determine whether InterQual criteria accurately predicted length of stay (LOS) in older patients with syncope. METHODS: We conducted a secondary analysis of a cohort study of adults >/=60 years of age who had syncope. We calculated InterQual criteria and classified the patient as observation or inpatient status. Outcomes were whether LOS were less than or greater than 2 midnights. RESULTS: We analyzed 2361 patients; 1227 (52.0%) patients were male and 1945 (82.8%) were white, with a mean age of 73.2 +/- 9.0 years. The median LOS was 32.6 h (interquartile range 24.2-71.8). The sensitivity of InterQual criteria for LOS was 60.8% (95% confidence interval 57.9-63.6%) and the specificity was 47.8% (95% confidence interval 45.0-50.5%). CONCLUSIONS: In older adults with syncope, those who met InterQual criteria for inpatient status had longer LOS compared with those who did not; however, the accuracy of the criteria to predict length of stay over 2 days is poor, with a sensitivity of 60% and a specificity of 48%. Future research should identify criteria to improve LOS prediction.
Identifier
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<a href="http://doi.org/10.1016/j.jemermed.2020.02.020" target="_blank" rel="noreferrer noopener">10.1016/j.jemermed.2020.02.020</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).
Format
The file format, physical medium, or dimensions of the resource
journalArticle
2020
Adler David H
Bastani Aveh
Baugh Christopher W
Case Management
Caterino Jeffrey M
Chang Anna Marie
Clark Carol L
Department of Emergency Medicine
Diercks Deborah B
Geriatrics
Hollander Judd E
InterQual
journalArticle
June 2020 Update II
Malveau Susan E
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
The Journal of emergency medicine
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
A name given to the resource
Variation in diagnostic testing for older patients with syncope in the emergency department
Publisher
An entity responsible for making the resource available
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
The topic of the resource
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
An unambiguous reference to the resource within a given context
<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