Evidence map›Paper›PMID 29367218›Full record

ArticleEmergency medicine journal : EMJ2018

Orthostatic blood pressure recovery patterns in suspected syncope in the emergency department.

Veera K van Wijnen, Dik Ten Hove, Reinold O B Gans, Wybe Nieuwland, Arie M van Roon, Jan C Ter Maaten, Mark P M Harms

Open access · hybridAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Emergency medicine journal : EMJ, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
1.7field-weighted citation impact, top 18% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 9 citations in OpenAlex.

  1. A cross-sectional nationwide survey of guideline based syncope units in the Netherlands: the SU-19 score-a novel validation for best practices.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2023
    Article
  2. Article
  3. Review
  4. Autonomic dysfunction in multiple sclerosis and other updates on recent autonomic research.Clinical autonomic research : official journal of the Clinical Autonomic Research Society · 2018
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 1 institution in 1 country.

Veera K van WijnenDepartment of Internal, Emergency and Vascular Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.ORCID http://orcid.org/0000-0003-1300-3836
Dik Ten HoveDepartment of Internal, Emergency and Vascular Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
Reinold O B GansDepartment of Internal, Emergency and Vascular Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
Wybe NieuwlandDepartment of Cardiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
Arie M van RoonDepartment of Internal, Emergency and Vascular Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
Jan C Ter MaatenDepartment of Internal, Emergency and Vascular Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
Mark P M HarmsDepartment of Internal, Emergency and Vascular Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
University Medical Center Groningen · NL

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionOrthostasis is a frequent trigger for (pre)syncope but some forms of orthostatic (pre)syncope have a worse prognosis than others. Routine assessment of orthostatic BP in the ED can detect classic orthostatic hypotension, but often misses these other forms of orthostatic (pre)syncope. This study aimed to determine the frequency of abnormal orthostatic BP recovery patterns in patients with (pre)syncope by using continuous non-invasive BP monitoring.

methodsWe performed a prospective cohort study in suspected patients with (pre)syncope in the ED of a tertiary care teaching hospital between January and August 2014. Orthostatic BP was measured during the active lying-to-standing test with Nexfin, a continuous non-invasive finger arterial pressure measurement device. Orthostatic BP recovery patterns were defined as normal BP recovery, initial orthostatic hypotension, delayed BP recovery, classic orthostatic hypotension and reflex-mediated hypotension.

resultsOf 116 patients recruited, measurements in 111 patients (age 63 years, 51% male) were suitable for analysis. Classic orthostatic hypotension was the most prevalent abnormal BP pattern (19%), but only half of the patients received a final diagnosis of orthostatic hypotension. Initial orthostatic hypotension and delayed BP recovery were present in 20% of the patients with (pre)syncope of whom 45% were diagnosed as unexplained syncope. Reflex-mediated hypotension was present in 4% of the patients.

conclusionContinuous non-invasive BP measurement can potentially identify more specific and concerning causes of orthostatic (pre)syncope. Correct classification is important because of different short-term and long-term clinical implications.

Indexed as

Academic Medical CentersAdultAgedAged, 80 and overBlood PressureBlood Pressure DeterminationCohort StudiesEmergency Service, HospitalFemaleHeart RateHumansHypotension, OrthostaticMaleMiddle AgedPostureProspective Studiesemergency departmentnon invasivevascular-arterial

Identifiers

PMID29367218
PMCPMC5868292
OpenAlexW2784824032

What OpenQuestion holds

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LicenceCC BY-NC
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.