+ Site Statistics
+ Search Articles
+ PDF Full Text Service
How our service works
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ Translate
+ Recently Requested

Prevalence of pulmonary embolism in patients presenting with syncope. A systematic review and meta-analysis



Prevalence of pulmonary embolism in patients presenting with syncope. A systematic review and meta-analysis



American Journal of Emergency Medicine 36(4): 551-555



Syncope is a common clinical presentation and establishing an etiology is often challenging. Pulmonary embolism (PE) has been thought to be an uncommon cause but a recent report suggested otherwise. To establish the prevalence of PE in patients presenting with syncope to the emergency department (ED) and in hospitalized patients. We systematically searched Medline, CINAHL, EMBASE, LILACS and Web of Science with relevant keywords and MeSH headings for syncope and PE. Inclusion criteria were patients presenting with syncope to ED or hospitalized due to syncope, and etiologies including PE. Of 1329 titles and abstracts, 12 (other than Prandoni et al.) met inclusion criteria. Nine studies included 6608 ED patients and 3 included 975 hospitalized patients. The mean age was 62 (95% CI 54-69) for ED patients and 67 (95% CI 64-70) for hospitalized. The pooled estimate of PE prevalence in ED syncope patients was 0.8% (95% CI 0.5-1.3%, I2=0%). The pooled estimate of PE prevalence in hospitalized patients was 1.0% (95% CI 0.5-1.9%, I2=0). In contrast, the prevalence of PE in Prandoni et al. were 3.8% and 17.3% for ED and hospitalized patients respectively, both significantly higher than in other relevant studies (p<0.0001). The estimated prevalence of PE in patients presenting with syncope is low. The Prandoni et al. estimates are significantly higher, suggesting a possible site effect, accrual bias, or investigation strategy. These and the prognostic impact of higher PE prevalence require understanding before changes in practice.

Please choose payment method:






(PDF emailed within 0-6 h: $19.90)

Accession: 060129281

Download citation: RISBibTeXText

PMID: 28947223

DOI: 10.1016/j.ajem.2017.09.015


Related references

Differential impact of syncope on the prognosis of patients with acute pulmonary embolism: a systematic review and meta-analysis. European Heart Journal 39(47): 4186-4195, 2018

Prevalence of Pulmonary Embolism in Patients Presenting With Syncope. Academic Emergency Medicine 26(5): 571-573, 2019

Prevalence of Pulmonary Embolism in Patients Presenting to the Emergency Department for Syncope. Advanced Emergency Nursing Journal 39(3): 161-167, 2017

Prevalence of pulmonary embolism in patients presenting to the emergency department with syncope. American Journal of Emergency Medicine 36(2): 253-256, 2018

Prevalence and Localization of Pulmonary Embolism in Unexplained Acute Exacerbations of COPD: A Systematic Review and Meta-analysis. Chest 151(3): 544-554, 2017

Syncope in patients with pulmonary embolism: comparison between patients with syncope as the presenting symptom of pulmonary embolism and patients with pulmonary embolism without syncope. Vascular Medicine 8(4): 257-261, 2003

Syncope in patients with pulmonary embolism: comparison between patients with syncope as the presenting symptom of pulmonary embolism and patients with pulmonary embolism without syncope. Vascular Medicine 8(4): 257-261, 2003

Prevalence of deep vein thrombosis and pulmonary embolism in patients with superficial vein thrombosis: a systematic review and meta-analysis. Journal of Thrombosis and Haemostasis 14(5): 964-972, 2016

Pulmonary embolism rule-out criteria (PERC) in pulmonary embolism--revisited: a systematic review and meta-analysis. Emergency Medicine Journal 30(9): 701-706, 2013

Cardiac Troponins in Low-Risk Pulmonary Embolism Patients: A Systematic Review and Meta-Analysis. Journal of Hospital Medicine 13(10): 706-712, 2018

Systematic review and meta-analysis for thrombolysis treatment in patients with acute submassive pulmonary embolism. Patient Preference and Adherence 8: 275-282, 2014

ERRATUM TO: Cardiac Troponins in Low-Risk Pulmonary Embolism Patients: A Systematic Review and Meta-Analysis. Journal of Hospital Medicine 13(7): 509-509, 2018

Non-vitamin K oral anticoagulants in patients with pulmonary embolism: a systematic review and meta-analysis of the literature. Internal and Emergency Medicine 10(4): 507-514, 2015

Systematic Review and Meta-analysis of Outcomes of Patients With Subsegmental Pulmonary Embolism With and Without Anticoagulation Treatment. Academic Emergency Medicine 25(7): 828-835, 2018

Prevalence of depressive symptoms in patients with chronic obstructive pulmonary disease: a systematic review, meta-analysis and meta-regression. General Hospital Psychiatry 33(3): 217-223, 2011