Dr. Emil Klosowiak
Not done going to trim and add pictures- OL
Syncopal/pre-syncopal episodes represent over 1 million emergency department visits each year.1 However, about half of these visits have a workup that does not reveal a clear etiology of the episode. This can create a dilemma in disposition of patients, particularly elderly patients who are higher risk for recurrence and secondary injury.
Probst, Marc A., et al. "Risk Stratification of Older Adults Who Present to the Emergency Department With Syncope: The FAINT Score." Annals of emergency medicine 75.2 (2020): 147-158.
The researchers conduced a prospective, observational study of older adults (>60 years) with unexplained syncope or near syncope who presented to 11 US Emergency Departments (ED). The study excluded patients with a serious diagnosis identified in the ED. Clinical and laboratory data was collected for all subjects which included N-terminal pro B-type natriuretic peptide (NT- proBNP) and fifth-generation high-sensitivity cardiac troponin T (hs-cTnT). The primary outcome was 30-day all-cause mortality or serious cardiac outcome. In addition, electronic medical records were reviewed at 30 days post initial encounter, as well as a telephone call to subjects to ascertain out-of-hospital deaths, ED visits or other hospitalizations. Initial ECGs were assessed by one of five physicians who were blinded to all other clinical data.
The incidence of the primary outcome at 30 days was 5.7% Using Bayesian logistic regression, the researchers derived the FAINT score.