作者: Stephen F. Derose , Gelareh Z. Gabayan , Vicki Y. Chiu , Benjamin C. Sun
DOI: 10.1111/J.1553-2712.2012.01336.X
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摘要: ACADEMIC EMERGENCY MEDICINE 2012; 19:488–496 © 2012 by the Society for Academic Emergency Medicine Abstract Objectives: The risk of short-term mortality after an emergency department (ED) visit syncope is poorly understood, resulting in prognostic uncertainty and frequent hospital admission. authors determined patterns factors a diagnosis or near to aid medical decision-making. Methods: A retrospective cohort study was performed adult members Kaiser Permanente Southern California seen at 11 EDs from 2002 2006 with primary discharge (International Classification Diseases, Ninth Revision [ICD-9] 780.2). outcome 30-day mortality. Proportional hazards time-to-event regression models were used identify factors. Results: There 22,189 participants 23,951 ED visits, 307 deaths 30 days. relatively lower death reached within 2 weeks ages 18 59 years, but not until 3 months more 60 older. Preexisting comorbidities associated increased included heart failure (hazard ratio [HR] = 14.3 HR = 3.09 79 years, HR = 2.34 80 years plus; all p < 0.001), diabetes (HR = 1.49, p = 0.002), seizure (HR = 1.65, p = 0.016), dementia (HR = 1.41, p = 0.034). If index followed one visits previous 30 days, it (HR = 1.86, p = 0.024). Absolute 30 days under 0.2% those 60 years without than 2.5% across failure. Conclusions: low patients younger old may be helpful when deciding who admit inpatient evaluation. presence that predict prior should considered clinical decisions stratification tools syncope. Close follow-up seems advisable older due prolonged death.