Highlights
- •Underlying cardiovascular disease increases the risk of syncopal fall.
- •Syncope patients were more likely to undergo diagnostic testing.
- •Syncope patients did not have a higher diagnostic yield to determine the etiology of syncope.
- •Selective syncope workup should be utilized based on comorbidities and clinical presentation.
Abstract
Background
Patients suspected of syncope frequently undergo laboratory and imaging studies to
determine the etiology of the syncope. Variability exists in these workups across
institutions. The purpose of this study was to evaluate the utilization and diagnostic
yield of these workups and the patient characteristics associated with syncopal falls.
Methods
A multi-institutional retrospective review was performed on adult patients admitted
after a fall between 1/2017–12/2018. Syncopal falls were compared to non-syncopal
falls.
Results
4478 patients were included. There were 795 (18%) patients with a syncopal fall. Electrocardiogram,
troponin, echocardiogram, CT angiography (CTA), and carotid ultrasound were more frequently
tested in syncope patients compared to non-syncope patients. Syncope patients had
higher rates of positive telemetry/Holter monitoring, CTAs, and electroencephalograms.
Conclusion
Patients who sustain syncopal falls frequently undergo diagnostic testing without
a higher yield to determine the etiology of syncope.
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Article info
Publication history
Published online: July 30, 2022
Accepted:
July 20,
2022
Received in revised form:
July 1,
2022
Received:
March 25,
2022
Identification
Copyright
© 2022 Elsevier Inc. All rights reserved.
