Prevalence of pulmonary embolism in patients presenting to the emergency department with syncope

Frizell, Alison W.; Fogel, Nicole; Steenblik, Jacob; Carlson, Margaret; Bledsoe, Joseph; Madsen, Troy

doi:10.1016/j.ajem.2017.07.090

Cited by 14 publications

(12 citation statements)

References 16 publications

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“…The rate of PE in patients with syncope in our study is in agreement with several other studies and is much lower than the rate found in the PESIT trial. However, the rates of testing for PE were not reported in these studies, suggesting the possibility of underascertainment.…”

Section: Discussionsupporting

confidence: 93%

“…The American College of Cardiology/American Heart Association/Heart Rhythm Society 2017 guidelines define syncope as “a symptom that presents with an abrupt, transient, complete loss of consciousness, associated with inability to maintain postural tone, with rapid and spontaneous recovery.” The etiologies of syncope range from benign to potentially life‐threatening pathologies . Pulmonary embolism (PE) is often considered as an etiology for syncope, but the likelihood of finding PE in patients presenting with syncope has varied substantially across studies . The Pulmonary Embolism in Syncope Italian Trial (PESIT) evaluated patients admitted to the hospital after their first syncopal episode and reported an overall prevalence of PE of 17.3% .…”

Section: Introductionmentioning

confidence: 99%

“…5,7,8 Pulmonary embolism (PE) is often considered as an etiology for syncope, but the likelihood of finding PE in patients presenting with syncope has varied substantially across studies. 5,[9][10][11][12][13] The Pulmonary Embolism in Syncope Italian Trial (PESIT) evaluated patients admitted to the hospital after their first syncopal episode and reported an overall prevalence of PE of 17.3%. 9 This reported prevalence rate was significantly higher than previous studies.…”

Section: Introductionmentioning

confidence: 99%

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Diagnostic yield of pulmonary embolism testing in patients presenting to the emergency department with syncope

Kelly

Bledsoe

Woller

et al. 2020

Research and Practice in Thrombosis and Haemostasis

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Background Syncope occurs in 1 in 4 people during their lifetime and accounts for 1% to 1.5% of emergency department (ED) visits. Most causes of syncope are benign, but syncope may be caused by life‐threatening conditions including pulmonary embolism (PE) in up to 2% of cases. A recent publication reported the prevalence of PE in patients with syncope to be over 17%. Aims We sought to determine the frequency and diagnostic yield of testing for PE in patients presenting to the ED with syncope in our large, integrated health care system. Methods We performed a retrospective, longitudinal cohort study of patients who presented with syncope to EDs within a 21‐hospital integrated health care system from 2010 to 2015 to find the frequency and diagnostic yield of testing for PE in patients with syncope at index ED visit and within 180 days afterward. Results We screened 2 749 371 ED encounters to find 32 440 (1.2%) with syncope. Median age was 52 (interquartile range, 31‐71), 57.5% were female, and 90% were Caucasian. PE was diagnosed on the index ED visit in 259 (0.8%; 95% confidence interval [CI], 0.7%‐0.9%) cases. Assessment for suspected PE with D‐dimer occurred in 5089 (15.7%) patients, and 2338 (7.2%) underwent computed tomography pulmonary angiography (CTPA). The yield of CTPA was 7.9%. PE was detected in 2.2% in whom a D‐dimer was performed. From index visit to 180 days, 467 (1.4%; 95% CI, 1.3%‐1.6%) patients were diagnosed with a PE, and 1051 (3.2%, 95% CI, 3.0%‐3.4%) patients died. Conclusion Diagnostic testing for PE is frequent in patients with syncope presenting to the EDs of a large, integrated health care system. The yield of diagnostic testing is low.

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Section: Discussionsupporting

confidence: 93%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Diagnostic yield of pulmonary embolism testing in patients presenting to the emergency department with syncope

Kelly

Bledsoe

Woller

et al. 2020

Research and Practice in Thrombosis and Haemostasis

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show abstract

“…48 Two other studies reported a PE prevalence of 1.4% among patients with syncope. 14,49 Routine screening for PE in all patients presenting with syncope may not be justified.…”

Section: Venous Thromboembolismmentioning

confidence: 99%

The year 2018 in cardiology: aorta and peripheral circulation

Aboyans

Vrsalović

Maďarič

et al. 2019

European Heart Journal

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“…33 In a recent paper published by Frizell et al, the results of the Prandoni study are also contested, as only 1.4% of patients were identified with PE from a total number of 348 of patients presenting with syncope in the ED. 34 These controverting results suggest the need of further investigations for the determination of the prevalence of PE in patients presenting with syncope in the ED.…”

Section: Syncope In Pementioning

confidence: 99%

Clinical Update. Clinical Presentations of Pulmonary Embolism in the Emergency Department

Barcan

Tarta

2017

Journal of Cardiovascular Emergencies

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Prevalence of pulmonary embolism in patients presenting to the emergency department with syncope

Cited by 14 publications

References 16 publications

Diagnostic yield of pulmonary embolism testing in patients presenting to the emergency department with syncope

Diagnostic yield of pulmonary embolism testing in patients presenting to the emergency department with syncope

The year 2018 in cardiology: aorta and peripheral circulation

Clinical Update. Clinical Presentations of Pulmonary Embolism in the Emergency Department

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