Observational studyAcademic emergency medicine : official journal of the Society for Academic Emergency Medicine2016
Short-term Prognosis and Current Management of Syncopal Patients at Intermediate Risk: Results from the IRiS (Intermediate-Risk Syncope) Study.
Observational study in Academic emergency medicine : official journal of the Society for Academic Emergency Medicine, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 3 of them syntheses that pooled it.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
10 citing papers in PubMed, 3 syntheses or guidelines pooled it, 25 citations in OpenAlex.
- Syncope Time Frames for Adverse Events after Emergency Department Presentation: An Individual Patient Data Meta-Analysis.Medicina (Kaunas, Lithuania) · 2021Pooled it
- Outcomes in syncope research: a systematic review and critical appraisal.Internal and emergency medicine · 2018Pooled it
- Predictors of Short-Term Outcomes after Syncope: A Systematic Review and Meta-Analysis.The western journal of emergency medicine · 2018Pooled it
- Cardiac findings and observation duration in patients with syncope in the emergency department: a cohort study.BMC emergency medicine · 2026Article
- National Cost Savings From Use of Artificial Intelligence Guided Echocardiography in the Assessment of Intermediate-Risk Patients With Syncope in the Emergency Department.Journal of the American College of Emergency Physicians open · 2025Article
- Comparison of syncope risk scores in predicting the prognosis of patients presenting to the emergency department with syncope.Irish journal of medical science · 2023Observational
- Patient factors associated with conveyance decision-making by Emergency Medical Services professionals in patients with a syncope: a cross-sectional factorial survey design.BMC emergency medicine · 2023Article
- Recurrent syncope is not an independent risk predictor for future syncopal events or adverse outcomes.The American journal of emergency medicine · 2019Observational
- Role of emergency department observation units in the management of patients with unexplained syncope: a critical review and meta-analysis.Clinical and experimental emergency medicine · 2017Review
- Syncope Risk Stratification in the Emergency Department: Another Step Forward.Academic emergency medicine : official journal of the Society for Academic Emergency Medicine · 2016Article
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Authors and funding
5 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesDespite guidelines, admission rates and expenditures for syncope remain high. This may be caused by an imprecise definition of cardiovascular disease considered at risk and an overestimation of the role of comorbidities and advanced age. In a cohort of patients with undetermined syncope, we prospectively compared the short-term prognosis of patients at intermediate risk (i.e., with stable heart diseases or comorbidities, of any age) versus those at high risk for cardiogenic syncope and identified factors associated with serious events. Secondarily, we analyzed the current management of intermediate-risk patients.
methodsIn a cohort of patients with undetermined syncope, we analyzed personal data, the presence of stable heart diseases or comorbidities, destination, length of hospitalization, incidence of serious events at 30 days, and costs.
resultsIn a 6-month period, 347 patients (185 male and 162 female, age 72.8 years) with undetermined syncope were enrolled, 250 at intermediate risk and 97 at high risk. Intermediate-risk patients were younger, with less frequent comorbidities and with a drastically lower incidence of serious events (0.8% vs. 27.8%, p < 0.001). Risk factors for cardiogenic syncope were the unique variable associated with serious events. Intermediate-risk patients were mostly admitted (62.8%) in an ordinary ward or into an emergency department observation unit; in the case of ordinary admission we observed a mean prolonged hospitalization (8.8 days), elevated costs ($270,183), and a high rate of unexplained syncope (51%).
conclusionsAccording to the results of this study, the authors believe that intermediate-risk patients could be safely discharged, with potentially significant costs saving. In prognostic stratification, priority is to seek risk factors for cardiogenic syncope while advanced age, stable heart diseases, or comorbidities likely lead to inappropriate hospitalization.
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