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Differential diagnosis
A simple algorithm improved physicians' diagnostic performance for patients presenting with syncope

https://doi.org/10.1136/ebm.5.6.191

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    (2000) Eur Heart J 21, 935. Ammirati F, Colivicchi F, Santini M, on behalf of the investigators of the OESIL study.. Diagnosing syncope in clinical practice. Implementation of a simplified diagnostic algorithm in a multicentre prospective trial—the OESIL 2 Study (Osservatorio Epidemiologico della Sincope nel Lazio).. Jun;. :. –40.
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 QUESTION: In patients presenting to the emergency department (ED) with syncope, what are the relative frequencies of different causes?

    Design

    2 month cohort study.

    Setting

    9 community hospitals in Italy.

    Patients

    195 patients who were >12 years of age (mean age 63 y, 56% women) and presented to the ED with syncope (sudden transient loss of consciousness and of postural tone with spontaneous recovery). Patients with a known seizure disorder with a prolonged postictal recovery phase or those without a clear loss of consciousness were excluded. Follow up was complete.

    Diagnostic strategy

    A 2 step diagnostic algorithm was applied to all patients. The first step consisted of a history and physical examination, 12 lead electrocardiogram …

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    Footnotes

    • Source of funding: not stated.

    • For correspondence: Dr F Ammirati, Dipartimento delle Malattie del Cuore, Ospedale S. Filippo Neri, Via Attilio Friggeri, 95, 00136 Rome, Italy.