Retrospective analysis of patients with dizziness evaluated in Syncope Unit: a real life experience

Abstract

Purpose To evaluate the characteristics of patients referred for dizziness to a Syncope Unit. Methods This is a retrospective study. Of 491 patients referred to the Syncope Unit of Careggi Hospital in 2015, 198 (40.3%) who experienced dizziness alone or associated with a history of transient loss of consciousness were enrolled. All the patients underwent an initial evaluation according to the European Society of Cardiology guidelines on syncope. We compared the clinical characteristics and final diagnosis of patients referred for dizziness alone (n = 64) to those of patients with dizziness and history of transient loss of consciousness (n = 134). Results The study population had a mean age of 62 ± 20 years (range 16-96 years) and 101 (51%) were female. A final diagnosis of pre-syncope was made in about the 80% of the patients without a previous history of transient loss of consciousness. In this group, other diagnoses were benign paroxysmal positional vertigo (6.3%), transient ischemic attack (4.7%) or psychogenic dizziness (7.8%). Syncope was diagnosed in the 82.7% of the patients with dizziness and history of transient loss of consciousness. Conclusion Dizziness was the main reason for referral to the Syncope Unit in almost one-third of the patients, in whom presyncope was the most frequent final diagnosis. Otological, neurological and psychiatric disorders should be also considered as differential diagnosis, highlighting the importance of a multidisciplinary approach.

STANDING update: A retrospective analysis in the Emergency Department one year after its validation

“…Similarly, we know that the 13% of patients referred to the Syncope Unit had dizziness and about the 4% had a peripheral vestibular disorder which had not been recognized during the first evaluation in the ED. 20 For the above reasons, we suggest a contextualization of the STANDING within a multidisciplinary network involving emergency physicians, syncope experts and audiologists, in order to standardize the physician's approach and the patient's management. In addition, a widespread application of the STANDING may limit possible errors in the differential diagnosis of dizziness, particularly for less experienced physicians.…”