International Journal of Cardiovascular ResearchISSN: 2324-8602

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Research Article, Int J Cardiovasc Res Vol: 4 Issue: 4

Utility of Routine Transthoracic Echocardiography in Hospitalized Syncope Patients Risk Stratified by EGSYS Score

Ali Shafiq1,2, Hardik Bhansali2, Meredith Mahan3 and Karthik Ananthasubramaniam4*
1Department of Cardiology, Saint Luke’s Mid America Heart Institute, Kansas City, USA
2Department of Internal Medicine, Henry Ford Hospital, Detroit, USA
3Department of Public Health Sciences, Henry Ford Hospital, Detroit, USA
4Heart and Vascular Institute, Henry Ford Hospital, Detroit, USA
Corresponding author : Karthik Ananthasubramaniam, MD
Heart and Vascular Institute, Henry Ford Hospital, 2799 W Grand Blvd, Detroit, MI 48202, USA
Tel: +3139164420; Fax: 313-916-8901
E-mail: [email protected]
Received: January 29, 2015 Accepted: April 06, 2015 Published: April 08, 2015
Citation: Shafiq A, Bhansali H, Mahan M, Ananthasubramaniam K (2015) Utility of Routine Transthoracic Echocardiography in Hospitalized Syncope Patients Risk Stratified by EGSYS Score. J Cardiovasc Res 4:4. doi:10.4172/2324-8602.1000215

Abstract

Utility of Routine Transthoracic Echocardiography in Hospitalized Syncope Patients Risk Stratified by EGSYS Score

Background: The yield of routine transthoracic echocardiography (TTE) in the diagnosis and risk stratification of syncope has been a subject of debate. Purpose and Methods: To compare the yield of TTE in different risk categories of syncope patients, we performed a retrospective study of patients who had a TTE with an admission diagnosis of syncope. The patients were then stratified into low and high risk categories based on their Evaluation of Guidelines in Syncope Study (EGSYS) score of <3 and >3, respectively. Three downstream health resources were evaluated: cardiology consultation, further testing and therapeutic interventions after TTE was done. Results: Of the study group, 65% (295/456) of patients were found to have utilized no downstream health resources. The remaining 35% (161/456) had at least used 1 resource; 29.2% (133/456) utilized 1, 5% (23/456) utilized 2 and 1.1% (5/456) utilized all 3 of these resources. Of the total study group, 51% (233/456) were low risk for cardiac syncope according to the EGSYS score. Only 23.2% (54/233) of these low risk patients utilized 1 or more of the downstream health resources, but no patients in this group needed any cardiac intervention. Conclusion: There was a significant difference of the yield and thus incremental value of TTE between high and low risk group categories based on the EGSYS score. A low EGSYS score seems to be a good initial tool in identifying patients who likely will not require additional interventions related to further downstream testing.

Keywords: Syncope; Transthoracic echocardiography; Yield; Utilization

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