Abstract
Background
Syncope is a common problem in children and adolescents. The diagnostic yield for
most tests commonly used in the evaluation of pediatric patients with syncope is low.
Study Objective
To examine the epidemiology of pediatric patients presenting to United States (US)
emergency departments (EDs) with a complaint of syncope and compare their initial
management to published guidelines.
Methods
ED visits from the National Hospital Ambulatory Medical Care Survey for 2003–2007
for patients aged 7–18 years were analyzed. Outcome variables were diagnostic tests
and management of patients presenting with syncope.
Results
There were 627,489 (95% confidence interval [CI] 527,237–727,722) ED visits for syncope
(0.9% of all ED visits for patients aged 7–18 years). Patients presenting to the ED
for syncope were more commonly female (p<0.01), adolescent (13–18 years) (p<0.01), covered by private insurance (p=0.01), and more likely to arrive to the ED by ambulance (p<0.01), compared to those presenting with other complaints. Only 58.1% (95% CI 50.3–66.0%)
of syncope patients received an electrocardiogram, and 26.5% (95% CI 18.2–34.7%) received
a computed tomography (CT) or magnetic resonance imaging (MRI) scan as part of their
diagnostic work-up.
Conclusions
When evaluating pediatric patients presenting with syncope, there should be an increased
use of the electrocardiogram to screen for underlying cardiac abnormalities. There
should also be a tempered use of CT/ MRI imaging in this population.
Keywords
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Article info
Publication history
Published online: March 14, 2012
Accepted:
January 16,
2012
Received in revised form:
August 2,
2011
Received:
June 8,
2011
Footnotes
This project was supported in part by cooperative agreement number U18 HS016957-03 from the Agency for Healthcare Research and Quality. The content is solely the responsibility of the authors and does not necessarily represent the official views of the Agency for Healthcare Research and Quality.
Identification
Copyright
© 2012 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
