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The inpatient management of syncope
  1. Laura C Tattersall1,
  2. Matthew J Reed2
  1. 1College of Medicine and Veterinary Medicine, University of Edinburgh, Edinburgh, UK
  2. 2Department of Emergency Medicine, Royal Infirmary of Edinburgh, Edinburgh, UK
  1. Correspondence to Matthew J Reed, Emergency Department, Royal Infirmary of Edinburgh, 51 Little France Crescent, Edinburgh EH16 4SA, UK; matthew.reed{at}


Introduction The management and risk stratification of patients with syncope in the Emergency Department (ED) has been the emphasis of much recent research, however little is known about inpatient management especially in the UK. The aim of this study was to examine the inpatient management of patients with syncope admitted to hospital from a UK ED.

Methods This was a single centre prospective observational cohort study, recruiting patients with syncope admitted to hospital from a UK ED. Inpatient management was examined focusing on length of stay and investigations undertaken.

Results Between 3 March 2007 and 22 July 2008, 540 patients presenting with syncope to the ED of the Royal Infirmary of Edinburgh, UK were admitted and enrolled. Median and mean length of stay was 1 day (IQR 1–4) and 6.3 days (SD 15.5). In all, 392 (73%) patients were admitted to General/Acute Medicine, 39 (7%) to Cardiology, 35 (7%) to Medicine of the Elderly, 33 (6%) to surgical specialities and the rest to other specialities. A diagnosis was finally made in 342 (63%) patients including 33 (85%) of the 39 admitted to Cardiology and 239 (61%) of the 392 patients admitted to General/Acute Medicine. The use of diagnostic tests varied between specialities with more intensive investigation undertaken in patients admitted to Cardiology.

Conclusions The current approach to the inpatient management of syncope is speciality dependent. Standardised diagnostic pathways may improve diagnostic yield and cost effectiveness.

  • Cardiac care
  • cardiac care
  • diagnosis

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  • Funding MR received funding from a Chief Scientist Office research fellowship (CSO/CAF/06/01). The sponsor of the study had no role in study design, data collection, data management, data analysis, data interpretation, or writing of the report. The corresponding author had full access to all the data in the study and has final responsibility for the decision to submit for publication.

  • Competing interests None.

  • Ethics approval This study was granted ethical approval by the Multi-Centre Research Ethics Committee for Scotland A (06/MRE00/107) and the Lothian Regional Ethical Committee (06/S11ADMIN/151).

  • Provenance and peer review Not commissioned; externally peer reviewed.

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