Should You Screen Syncope Patients for Pulmonary Embolism?

Pulmonary embolism (PE) does not commonly occur in patients with syncope, a new study showed, suggesting that not all patients with syncope should be evaluated for PE.

From January 1, 2000, to September 30, 2016, the researchers collected and evaluated data on 1,671,944 adults from 4 different countries who presented to the emergency department (ED) with syncope. Syncope diagnoses were identified through screening of patient data for syncope codes at discharge.
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Ultimately, PE was not found to be common among patients with syncope. Findings showed that PE had occurred in 0.06% to 0.55% of all patients and in 0.15% to 2.10% of hospitalized patients. At 90 days of follow-up, PE was prevalent in 0.14% to 0.83% of all patients and in 0.35% to 2.63% of hospitalized patients.

The researchers also noted that, at 90 days, venous thromboembolism had occurred in 0.30% to 1.37% of all patients and 0.75% to 3.86% of hospitalized patients.

“[PE] was rarely identified in patients with syncope,” the researchers concluded. “Although PE should be considered in every patient, not all patients should undergo evaluation for PE.”

—Christina Vogt

Reference:

Constantino G, Ruwald MH, Quinn J, et al. Prevalence of pulmonary embolism in patients with syncope [Published online January 29, 2018]. JAMA Intern Med. doi:10.1001/jamainternmed.2017.8175.