THE SYNCOPE WORKUP: IS AN ECHOCARDIOGRAM WORTH ACQUIRING?

TOPIC: Education, Research, and Quality Improvement TYPE: Original Investigations PURPOSE: The aim of our study is to assess the role echocardiography in patients who were admitted hospital with syncope, primarily terms cost-effectiveness. Despite studies that have found little utility ordering routine echocardiograms without risk factors for cardiac disease (1,2), there are still several ordered presenting syncope. Although may be beneficial those previous abnormal (2) or ECG, they otherwise low-yield young low-risk (3) would suggest this incurs unnecessary costs both system. Our therefore set out evaluate usage echocardiogram syncope determine cost effectiveness patient population. METHODS: We conducted a retrospective observational 195 discharge diagnosis codes Of these, 169 worked up ER notes, admission history physical, electrocardiogram (ECG), orthostatic vitals documentation, cardiology consultation, telemetry (TTE) results carefully reviewed. Patients then separated into normal versus ECG groups, prior TTE also documented. RESULTS: Eighty-six had twenty-four (14.2 % group) results. Seven (4.1%) change management from seven patients, two severe aortic stenosis other arrests. remaining myocardial infarction, large pericardial effusion, new atrial fibrillation tachycardia induced cardiomyopathy respectively. Ninety-one (55.8%) EKG about half them ordered, only 8.8% demonstrating some abnormality. Seventy-two EKGs roughly thirds TTE. In group, echo was 19.4%. Orthostatic 34% group 73.3% age more than 60 years old. CONCLUSIONS: Very few truly help us distinguish cause varies by state region, however, can hundred dollars.Thus, given low yield impact on management, every not effective. At local community particular, poses excessive underserved population offering benefit impacting management. CLINICAL IMPLICATIONS: Other causes worth noting before TTE, as 73% at hypotension considering their but vitals. DISCLOSURES: No relevant relationships Fnu Abhishek, source=Web Response Abdelrhman Abo-zed, Abasin Amanzai, Zachary Bugos, Noor-ul-huda Mehdi, Sowjanya Yenigalla,