Desenlaces a un año en pacientes con síncope de alto y bajo riesgo

Abstract

IntroductionSyncope is a complex symptom to assess, and is a diagnostic challenge. The inadequate risk stratification can lead to the inappropriate use of health resources and to an increase in the costs arising from the care. ObjectiveTo compare the outcomes at one year in patients with high and low risk syncope in four Bogota hospitals. Material and methodA retrospective cohort study was conducted that included patients over 18 years-old that were seen in the Emergency Department due to a syncope. They were followed-up from February 2013 until July 2015. They were classified into low and high risk according to the score on the scale of Martin et al. At one year, a telephone call follow-up was made to assess the outcomes. ResultsThe high risk patients had higher rates of mortality and recurrence of syncope, required more hospital admissions, had more neurological events, and a greater need for cardiac intervention. The overall mortality was 6%, and in sub-group of patients with a higher score (4 points) it increased to 16.6%. The majority of events occurred in the first 6 months of follow-up. The mortality and the need for cardiovascular intervention were associated with the increase in the score on the scale. ConclusionPatients classified as high risk according to the scale of Martin et al. are more likely to have adverse outcomes at one year of follow-up, and thus could benefit from a larger study and directed at the cause of the syncope.