SYNCOPE: THE ROLE OF SYNCOPE UNIT
Management of syncope: clinical and economic impact of a Syncope Unit
1 Department of Cardiology, G.B. Grassi Hospital, Via Passeroni 28, Ostia Lido, Roma, Italy; 2 Center for the Study of Syncope, Policlinico Umberto I, Roma, Italy; 3 Medtronic Italia SpA, Sesto S. Giovanni, MI, Italy; 4 Department of Cardiology, S. Filippo Neri Hospital, Roma, Italy
Aims: Aim of this observational study is to evaluate the clinical performance of a Syncope Unit, in order to assess whether the implemented organization really improves syncope management.
Methods and results: The study enrolled patients with unexplained syncope who were consecutively referred to our Syncope Unit, either as outpatients or during hospitalization, in a 2-month period. The design of this observational study consists in three phases: a retrospective analysis of their clinical management in the 9 months prior to the first attendance at the Syncope Unit (phase one), their subsequent clinical management in the Syncope Unit (phase two) and a 9-month follow-up (phase three). The retrospective analysis of phase one showed that 25% of patients had already been hospitalized without diagnosis. After Syncope Unit evaluation, diagnosis was obtained in 82% of patients, with 15% of patients indicated to pacing. In the follow-up, 23% of patients experienced a syncopal recurrence. Our analysis indicated an 85% reduction of hospital costs in the follow-up period.
Conclusion: The clinical and economic analysis of the three phases of our study demonstrates that a Syncope Unit allows an improved management of patients with syncope.
Key Words: Syncope Unit, Guidelines, Loss of consciousness, OESIL risk score, Pacemaker
* Corresponding author. Tel: +39 06 354024444; fax: +39 06 56482177. E-mail address: fabammirati{at}alice.it
Manuscript submitted 12 September 2007. Accepted after revision 13 February 2008.