ISSN: 1223-1533

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EVALUATION OF CLINICAL USEFULNESS OF STANDARDIZED, QUESTIONNAIRE-BASED HISTORY EVALUATION IN THE DIAGNOSIS OF SYNCOPE


Authors: Artur Z. Pietrucha, Irena Bzukala, Mateusz Wnuk, Wieslawa Piwowarska, Jadwiga Nessler




 

The aim of our study was evaluation of clinical usefulness of standardized, questionnaire-based history evaluation in the diagnosis of syncope in patients admitted to Syncopal Unit.

 

Material and methods: We observed 920 consecutive pts. with syncope (552 women, 60%, aged 12-89 yrs., median of age 41 yrs.), diagnosed in our Syncopal Unit of our Department during last 3 years.In all patients a of standardized questionnaire for history evaluation (SQfHE) was used during initial evaluation together with physical examination, ECG evaluation , orthostatic BP measurement and carotid sinus massage in pts. over 40 years of age. This questionnaire included question regarding circumstances of syncopal episodes, evaluation of prodroms and syncope course according to last ESC guidelines for diagnosis and treatment of syncope. Calgary Syncope Symptom Score (CSSS) proposed by Sheldon as well as OESIL Score (OS) were implemented into SQfHE. If CSSS was -2 or more reflex syncope was diagnosed or suspected – if concomitant disorders  were  presented.  If  OS  was  higher  than  0 additional diagnosis was performed.

 

Results: Based on initial evaluation diagnosis of syncope was done in 42,4% of pts., Suspected diagnosis of syncope was made in further 39,6% of pts. Only 18 % of patient had no established the reason of syncope based on initial evaluation. Hospitalization rate, longer than 1 day was 8,2%

 

Conclusions:

  1. Standardized, questionnaire-based history evaluation is very useful in the diagnosis of patients with syncope admitted to Syncopal Unit.
  2. Standardized, questionnaire-based history evaluation allow to make diagnosis, based only on initial evaluation in over 40% of patients.
  3. The ratio of undiagnosed syncope based on initial evaluation was only 18% – in these patients the additional diagnosis was performed.
  4. Standardized, questionnaire-based history evaluation is also useful in limitation of hospitalization rate needed for diagnosis of patients with syncope