Evidence map›Paper›PMID 40990887›Full record

Observational studyAnnals of emergency medicine2026

Serious Cardiac Outcomes and Physician Estimation of Risk in Emergency Department Patients With Presyncope Versus Syncope.

Edward H Suh, Dana L Sacco, Carolyn Winskill, John DeAngelis, Daniel Nishijima, Jonathan Schimmel, Alan Storrow, Venkatesh Thiruganasambandamoorthy, Robert E Weiss, Nancy Wood and 1 more

Abstract readObservational StudyMulticenter StudyComparative Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in Annals of emergency medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
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

1 citing paper in PubMed.

  1. Observational
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

11 authors.

Edward H SuhDepartment of Emergency Medicine, Columbia University Irving Medical Center, New York, NY. Electronic address: ehs2109@columbia.edu.
Dana L SaccoDepartment of Emergency Medicine, Columbia University Irving Medical Center, New York, NY.
Carolyn WinskillDepartment of Biostatistics, University of California, Los Angeles, Los Angeles, CA.
John DeAngelisDepartment of Emergency Medicine, University of Rochester Medical Center, Rochester, NY.
Daniel NishijimaDepartment of Emergency Medicine, University of California Davis, Sacramento, CA.
Jonathan SchimmelDepartment of Emergency Medicine, The Mount Sinai Hospital, New York, NY.
Alan StorrowDepartment of Emergency Medicine, Vanderbilt University Medical Center, Nashville, TN.
Venkatesh ThiruganasambandamoorthyDepartment of Emergency Medicine, University of Ottawa, Ottawa, ON, Canada.
Robert E WeissDepartment of Biostatistics, University of California, Los Angeles, Los Angeles, CA.
Nancy WoodDepartment of Emergency Medicine, University of Rochester Medical Center, Rochester, NY.
Marc A ProbstDepartment of Emergency Medicine, Columbia University Irving Medical Center, New York, NY.

Funding

Vanderbilt Institute for Clinical and Translational Research (VICTR) -Identifying correlates of functional immunity in SARS-CoV-2 convalescent plasmaUL1TR002243 · NCATS · VANDERBILT UNIVERSITY MEDICAL CENTER · PI Paul A. Harris, Wesley H Self · 2017 to 2026
$130.7M
Institutional Career Development CoreKL2TR001874 · NCATS · COLUMBIA UNIVERSITY HEALTH SCIENCES · PI GENKINGER, JEANINE M., SHIMBO, DAICHI · 2016 to 2025
$13.6M
Practical Approaches to Care in Emergency Syncope (PACES)R01HL149680 · NHLBI · ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI · PI PROBST, MARC · 2020 to 2024
$4.6M
Mechanism(s) Underlying Hypotensive Response to ARB/NEP InhibitionR01HL145293 · NHLBI · YALE UNIVERSITY · PI BROWN, NANCY J., STEVENSON, LYNNE W · 2020 to 2024
$3.1M
Tailored dissemination and implementation of emergency care clinical decision support to improve emergency department dispositionR01HL157596 · NHLBI · VANDERBILT UNIVERSITY MEDICAL CENTER · PI KRIPALANI, SUNIL, LIU, DANDAN · 2021 to 2024
$3.0M
Vanderbilt Interdisciplinary Hospital-Based Systems of Care Research and Training ProgrAm (VISTA)T32HL170986 · NHLBI · VANDERBILT UNIVERSITY MEDICAL CENTER · PI SUNIL KRIPALANI, ALAN B STORROW · 2024 to 2026
$1.3M
A Randomized Trial of Protocolized Diuretic Therapy Compared to Standard Care in Emergency Department Patients with Acute Heart FailureR61HL155810 · NHLBI · VANDERBILT UNIVERSITY MEDICAL CENTER · PI COLLINS, SEAN PATRICK · 2021 to 2021
$881k
AHRQ HHS R18 HS025931NCATS NIH HHS KL2 TR001874NCATS NIH HHS UL1 TR002243NHLBI NIH HHS R01 HL145293NHLBI NIH HHS R01 HL149680NHLBI NIH HHS R01 HL157596NHLBI NIH HHS R61 HL155810NHLBI NIH HHS T32 HL170986
6 · The paper itself

Abstract

STUDY

objectivePrevious research suggests that the short-term incidence of adverse events is similar in emergency department (ED) patients with presyncope and syncope. However, admission rates for presyncope are lower, which could imply clinicians underestimate its risk. We sought to compare physician risk estimates and the 30-day rate of serious cardiac outcomes between patients with syncope and presyncope.

methodsWe conducted a secondary analysis of a prospective, observational, multicenter study of patients aged ≥40 years presenting to ED with presyncope or syncope. Patients with serious ED diagnoses were excluded. Descriptive statistics and multivariable regression analyses were used to compare the physician-estimated risk, ED disposition, and 30-day rate of adverse outcomes.

resultsOf the 1,263 patients analyzed, 721 (57%) had syncope and 542 (43%) had presyncope. Baseline characteristics were similar between groups. At 30 days, 34 (4.7%) syncope patients and 28 (5.2%) presyncope patients experienced a serious cardiac outcome; logistic regression showed no difference in the odds (odds ratio 1.13; 95% confidence interval 0.66 to 1.79) of serious cardiac outcomes between syncope and presyncope patients. The mean physician-estimated risk of serious cardiac outcomes was 7.6% in syncope, versus 5.3% in presyncope (risk difference 2.3% [0.89%, 3.7%]); this difference remained significant after adjustment for clinical characteristics. Admission rate was lower in presyncope, 38.2% versus 49.5% (risk difference 11.3% [1.2%, 21.5%]).

conclusionPatients with unexplained presyncope and syncope had similar rates of 30-day serious cardiac outcomes after ED visit. Patients with presyncope were less likely to be admitted and had a lower mean physician-estimated risk of adverse outcomes.

Indexed as

Emergency Service, HospitalSyncopeAdultAgedFemaleHumansMaleMiddle AgedProspective StudiesRisk AssessmentNear syncopePhysician risk estimationPresyncopeRisk stratificationSyncope

Identifiers

PMID40990887
PMCPMC12462893

What OpenQuestion holds

Textmetadata
Read underepoch 390

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.