Predictors of Short-Term Outcomes after Syncope: A Systematic Review and Meta-Analysis

The Western Journal of Emergency Medicine
Thomas A GibsonBenjamin C Sun

Abstract

We performed a systematic review and meta-analysis to identify predictors of serious clinical outcomes after an acute-care evaluation for syncope. We identified studies that assessed for predictors of short-term (≤30 days) serious clinical events after an emergency department (ED) visit for syncope. We performed a MEDLINE search (January 1, 1990 - July 1, 2017) and reviewed reference lists of retrieved articles. The primary outcome was the occurrence of a serious clinical event (composite of mortality, arrhythmia, ischemic or structural heart disease, major bleed, or neurovascular event) within 30 days. We estimated the sensitivity, specificity, and likelihood ratio of findings for the primary outcome. We created summary estimates of association on a variable-by-variable basis using a Bayesian random-effects model. We reviewed 2,773 unique articles; 17 met inclusion criteria. The clinical findings most predictive of a short-term, serious event were the following: 1) An elevated blood urea nitrogen level (positive likelihood ratio [LR+]: 2.86, 95% confidence interval [CI] [1.15, 5.42]); 2); history of congestive heart failure (LR+: 2.65, 95%CI [1.69, 3.91]); 3) initial low blood pressure in the ED (LR+: 2.62, 95%CI [1.12, 4.9]);...Continue Reading

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Citations

Feb 6, 2019·Academic Emergency Medicine : Official Journal of the Society for Academic Emergency Medicine·Carol L ClarkBenjamin C Sun
Mar 4, 2020·Journal of Clinical Medicine·Francisco Martín-RodríguezJosé Luis Martín-Conty
Oct 18, 2019·Diagnosis·Giuseppe LippiFabian Sanchis-Gomar
Aug 15, 2020·Frontiers in Cardiovascular Medicine·Stanisław FurtanDorota Zyśko
Jan 1, 2021·Academic Emergency Medicine : Official Journal of the Society for Academic Emergency Medicine·Rachel A L SweanorEdward E Etchells
Mar 21, 2020·JACC. Clinical Electrophysiology·Rochelle BernierRoopinder K Sandhu

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