Asunto(s)
Vesícula/diagnóstico , Vesícula/terapia , Infecciones por Clostridium/diagnóstico , Infecciones por Clostridium/terapia , Infecciones de los Tejidos Blandos/diagnóstico , Infecciones de los Tejidos Blandos/terapia , Anciano de 80 o más Años , Antibacterianos/uso terapéutico , Brazo , Vesícula/microbiología , Infecciones por Clostridium/microbiología , Clostridium septicum/aislamiento & purificación , Terapia Combinada , Desbridamiento , Diabetes Mellitus Tipo 2 , Diagnóstico Diferencial , Fluidoterapia , Humanos , Masculino , Infecciones de los Tejidos Blandos/microbiologíaRESUMEN
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.