Patient characteristics and diagnostic tests associated with syncopal falls: A Southwestern surgical congress multicenter study

Janet S Lee; Abid D Khan; Christopher M Quinn; Kathryn Colborn; Deven C Patel; Galinos Barmparas; Daniel R Margulies; Christine J Waller; Kara J Kallies; Alec J Fitzsimmons; Shanu N Kothari; Alexander R Raines; Heidi Mahnken; Julie Dunn; Linda Zier; Robert C McIntyre Jr; Shane Urban; Julia R Coleman; Eric M Campion; Clay C Burlew; Thomas J Schroeppel

doi:10.1016/j.amjsurg.2022.07.018

Patient characteristics and diagnostic tests associated with syncopal falls: A Southwestern surgical congress multicenter study

Am J Surg. 2022 Dec;224(6):1374-1379. doi: 10.1016/j.amjsurg.2022.07.018. Epub 2022 Jul 31.

Authors

Janet S Lee¹, Abid D Khan², Christopher M Quinn³, Kathryn Colborn⁴, Deven C Patel⁵, Galinos Barmparas⁶, Daniel R Margulies⁷, Christine J Waller⁸, Kara J Kallies⁹, Alec J Fitzsimmons¹⁰, Shanu N Kothari¹¹, Alexander R Raines¹², Heidi Mahnken¹³, Julie Dunn¹⁴, Linda Zier¹⁵, Robert C McIntyre Jr¹⁶, Shane Urban¹⁷, Julia R Coleman¹⁸, Eric M Campion¹⁹, Clay C Burlew²⁰, Thomas J Schroeppel²¹

Affiliations

¹ Department of Trauma and Acute Care Surgery, UCHealth Memorial Hospital, Colorado Springs, CO, USA; Department of Surgery, University of Colorado Anschutz Medical Campus, Aurora, CO, USA. Electronic address: janet.lee@cuanschutz.edu.
² Department of Surgery, Division of Trauma and Acute Care Surgery, University of Chicago, Chicago, IL, USA. Electronic address: adkhan@gmail.com.
³ Department of Surgery, University of Colorado Anschutz Medical Campus, Aurora, CO, USA; Surgical Outcomes and Applied Research, University of Colorado Anschutz Medical Campus, Aurora, CO, USA. Electronic address: Christopher.2.quinn@cuanschutz.edu.
⁴ Department of Surgery, University of Colorado Anschutz Medical Campus, Aurora, CO, USA; Surgical Outcomes and Applied Research, University of Colorado Anschutz Medical Campus, Aurora, CO, USA. Electronic address: Kathryn.colborn@cuanschutz.edu.
⁵ Department of Surgery, Cedars-Sinai Medical Center, Los Angeles, CA, USA. Electronic address: Deven.Patel@cshs.org.
⁶ Department of Surgery, Cedars-Sinai Medical Center, Los Angeles, CA, USA. Electronic address: galinos.barmparas@cshs.org.
⁷ Department of Surgery, Cedars-Sinai Medical Center, Los Angeles, CA, USA. Electronic address: daniel.margulies@cshs.org.
⁸ Department of Surgery, Gundersen Health System, La Crosse, WI, USA. Electronic address: cjwaller@gundersenhealth.org.
⁹ Department of Medical Research, Gundersen Health System, La Crosse, WI, USA. Electronic address: kjkallie@gundersenhealth.org.
¹⁰ Department of Medical Research, Gundersen Health System, La Crosse, WI, USA. Electronic address: ajfitzsi@gundersenhealth.org.
¹¹ Department of General Surgery, Prisma Health, Greenville, SC, USA. Electronic address: Shanu.Kothari@prismahealth.org.
¹² Department of Surgery, University of Oklahoma Health Science Center, Oklahoma City, OK, USA. Electronic address: alexander-raines@ouhsc.edu.
¹³ Department of Surgery, University of Oklahoma Health Science Center, Oklahoma City, OK, USA. Electronic address: mahnkenheidi@gmail.com.
¹⁴ Department of Trauma and Acute Care Surgery, UCHealth Medical Center of the Rockies, Loveland, CO, USA. Electronic address: Julie.Dunn@uchealth.org.
¹⁵ Department of Trauma and Acute Care Surgery, UCHealth Medical Center of the Rockies, Loveland, CO, USA. Electronic address: linda.zier@uchealth.org.
¹⁶ Department of Surgery, University of Colorado Anschutz Medical Campus, Aurora, CO, USA. Electronic address: Robert.mcintyre@cuanschutz.edu.
¹⁷ Department of Surgery, University of Colorado Anschutz Medical Campus, Aurora, CO, USA. Electronic address: Shane.Urban@uchealth.org.
¹⁸ Department of Surgery, University of Colorado Anschutz Medical Campus, Aurora, CO, USA; Department of Surgery, Denver Health Medical Center, Denver, CO, USA. Electronic address: julia.coleman@cuanschutz.edu.
¹⁹ Department of Surgery, Denver Health Medical Center, Denver, CO, USA. Electronic address: eric.campion@dhha.org.
²⁰ Department of Surgery, Denver Health Medical Center, Denver, CO, USA. Electronic address: clay.burlew@cuanschutz.edu.
²¹ Department of Trauma and Acute Care Surgery, UCHealth Memorial Hospital, Colorado Springs, CO, USA. Electronic address: Thomas.schroeppel@uchealth.org.

PMID: 35940931
DOI: 10.1016/j.amjsurg.2022.07.018

Abstract

Background: Patients suspected of syncope frequently undergo laboratory and imaging studies to determine the etiology of the syncope. Variability exists in these workups across institutions. The purpose of this study was to evaluate the utilization and diagnostic yield of these workups and the patient characteristics associated with syncopal falls.

Methods: A multi-institutional retrospective review was performed on adult patients admitted after a fall between 1/2017-12/2018. Syncopal falls were compared to non-syncopal falls.

Results: 4478 patients were included. There were 795 (18%) patients with a syncopal fall. Electrocardiogram, troponin, echocardiogram, CT angiography (CTA), and carotid ultrasound were more frequently tested in syncope patients compared to non-syncope patients. Syncope patients had higher rates of positive telemetry/Holter monitoring, CTAs, and electroencephalograms.

Conclusion: Patients who sustain syncopal falls frequently undergo diagnostic testing without a higher yield to determine the etiology of syncope.

Publication types

Multicenter Study

MeSH terms

Adult
Diagnostic Tests, Routine / adverse effects
Echocardiography
Humans
Syncope* / diagnosis
Syncope* / etiology
Telemetry* / adverse effects