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Syncope in the emergency department of a large northern Italian hospital: incidence, efficacy of a short-stay observation ward and validation of the OESIL risk score
  1. Filippo Numeroso1,
  2. Gianluigi Mossini1,
  3. Eleonora Spaggiari2,
  4. Gianfranco Cervellin1
  1. 1Emergency Department, University Hospital of Parma, Parma, Italy
  2. 2Department of Internal Medicine and Biomedical Sciences of the University of Parma, Parma, Italy
  1. Correspondence to Dr Filippo Numeroso, Strada Garibaldi 31, 43121, Parma, Italy; ffilo{at}


Objective Syncope causes 1–3% of all emergency department (ED) visits, a high percentage of hospitalisations and prolonged hospital stay; nevertheless, many cases remain unexplained.

Methods This study analysed the incidence of syncope at the ED of the University Hospital of Parma in the first half of 2008; then a sample of 200 patients admitted later for syncope into the ED ward was studied, in order to evaluate the efficacy of a brief observation unit and to validate the Osservatorio Epidemiologico della Sincope nel Lazio (OESIL) risk score as a tool to identify cardiogenic syncopes.

Results and Conclusions As reported in the literature, syncope accounts for 2.3% of ED consultations and for 4.2% of total hospital admissions. A brief observation ward in the ED seems to have the necessary characteristics for managing most cases of syncope quickly (3.5 days). The final diagnosis was certain in 60%, suspected in 33% and unexplained in 7% of patients. The commonest forms of syncope were non-cardiogenic. Factors associated with cardiogenic syncope were previous syncopal events, lack of prodromal symptoms and a high OESIL risk score.

  • emergency department
  • incidence
  • OESIL risk score
  • short-stay ward
  • syncope

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  • Competing interests None.

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