Prevalence of Pulmonary Embolism in Patients With Syncope
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Prevalence of Pulmonary Embolism in Patients With Syncope. / Costantino, Giorgio; Ruwald, Martin H; Quinn, James; Camargo, Carlos A; Dalgaard, Frederik; Gislason, Gunnar; Goto, Tadahiro; Hasegawa, Kohei; Kaul, Padma; Montano, Nicola; Numé, Anna-Karin; Russo, Antonio; Sheldon, Robert; Solbiati, Monica; Sun, Benjamin; Casazza, Giovanni.
I: JAMA Internal Medicine, Bind 178, Nr. 3, 2018, s. 356-362.Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
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TY - JOUR
T1 - Prevalence of Pulmonary Embolism in Patients With Syncope
AU - Costantino, Giorgio
AU - Ruwald, Martin H
AU - Quinn, James
AU - Camargo, Carlos A
AU - Dalgaard, Frederik
AU - Gislason, Gunnar
AU - Goto, Tadahiro
AU - Hasegawa, Kohei
AU - Kaul, Padma
AU - Montano, Nicola
AU - Numé, Anna-Karin
AU - Russo, Antonio
AU - Sheldon, Robert
AU - Solbiati, Monica
AU - Sun, Benjamin
AU - Casazza, Giovanni
PY - 2018
Y1 - 2018
N2 - Importance: Sparse data and conflicting evidence exist on the prevalence of pulmonary embolism (PE) in patients with syncope.Objective: To estimate the prevalence of PE among patients presenting to the emergency department (ED) for evaluation of syncope.Design, Setting, and Participants: This retrospective, observational study analyzed longitudinal administrative data from 5 databases in 4 different countries (Canada, Denmark, Italy, and the United States). Data from all adult patients (aged ≥18 years) who presented to the ED were screened to identify those with syncope codes at discharge. Data were collected from January 1, 2000, through September 30, 2016.Main Outcomes and Measures: The prevalence of PE at ED and hospital discharge, identified using codes from the International Classification of Diseases, was considered the primary outcome. Two sensitivity analyses considering prevalence of PE at 90 days of follow-up and prevalence of venous thromboembolism were performed.Results: A total of 1 671 944 unselected adults who presented to the ED for syncope were included. The prevalence of PE, according to administrative data, ranged from 0.06% (95% CI, 0.05%-0.06%) to 0.55% (95% CI, 0.50%-0.61%) for all patients and from 0.15% (95% CI, 0.14%-0.16%) to 2.10% (95% CI, 1.84%-2.39%) for hospitalized patients. The prevalence of PE at 90 days of follow-up ranged from 0.14% (95% CI, 0.13%-0.14%) to 0.83% (95% CI, 0.80%-0.86%) for all patients and from 0.35% (95% CI, 0.34%-0.37%) to 2.63% (95% CI, 2.34%-2.95%) for hospitalized patients. Finally, the prevalence of venous thromboembolism at 90 days ranged from 0.30% (95% CI, 0.29%-0.31%) to 1.37% (95% CI, 1.33%-1.41%) for all patients and from 0.75% (95% CI, 0.73%-0.78%) to 3.86% (95% CI, 3.51%-4.24%) for hospitalized patients.Conclusions and Relevance: Pulmonary embolism was rarely identified in patients with syncope. Although PE should be considered in every patient, not all patients should undergo evaluation for PE.
AB - Importance: Sparse data and conflicting evidence exist on the prevalence of pulmonary embolism (PE) in patients with syncope.Objective: To estimate the prevalence of PE among patients presenting to the emergency department (ED) for evaluation of syncope.Design, Setting, and Participants: This retrospective, observational study analyzed longitudinal administrative data from 5 databases in 4 different countries (Canada, Denmark, Italy, and the United States). Data from all adult patients (aged ≥18 years) who presented to the ED were screened to identify those with syncope codes at discharge. Data were collected from January 1, 2000, through September 30, 2016.Main Outcomes and Measures: The prevalence of PE at ED and hospital discharge, identified using codes from the International Classification of Diseases, was considered the primary outcome. Two sensitivity analyses considering prevalence of PE at 90 days of follow-up and prevalence of venous thromboembolism were performed.Results: A total of 1 671 944 unselected adults who presented to the ED for syncope were included. The prevalence of PE, according to administrative data, ranged from 0.06% (95% CI, 0.05%-0.06%) to 0.55% (95% CI, 0.50%-0.61%) for all patients and from 0.15% (95% CI, 0.14%-0.16%) to 2.10% (95% CI, 1.84%-2.39%) for hospitalized patients. The prevalence of PE at 90 days of follow-up ranged from 0.14% (95% CI, 0.13%-0.14%) to 0.83% (95% CI, 0.80%-0.86%) for all patients and from 0.35% (95% CI, 0.34%-0.37%) to 2.63% (95% CI, 2.34%-2.95%) for hospitalized patients. Finally, the prevalence of venous thromboembolism at 90 days ranged from 0.30% (95% CI, 0.29%-0.31%) to 1.37% (95% CI, 1.33%-1.41%) for all patients and from 0.75% (95% CI, 0.73%-0.78%) to 3.86% (95% CI, 3.51%-4.24%) for hospitalized patients.Conclusions and Relevance: Pulmonary embolism was rarely identified in patients with syncope. Although PE should be considered in every patient, not all patients should undergo evaluation for PE.
U2 - 10.1001/jamainternmed.2017.8175
DO - 10.1001/jamainternmed.2017.8175
M3 - Journal article
C2 - 29379959
VL - 178
SP - 356
EP - 362
JO - JAMA Internal Medicine
JF - JAMA Internal Medicine
SN - 2168-6106
IS - 3
ER -
ID: 215365862