Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Prospective multi centre cohort study examining the clinical presentation, diagnostic tests, and management of adult Emergency Department (ED) patients presenting with Transient Loss of Consciousness (TLOC) either undifferentiated or thought to be of syncopal origin.
Syncope is a common ED problem. The three underlying causes are reflex (simple faint), orthostatic hypotension (blood pressure fall on standing) and cardiac disease (structural heart disease or cardiac dysrhythmia). Diagnosis is difficult and is not apparent in ~50% of patients after assessment. For the first time, European Society of Cardiology (ESC) guidelines incorporating ED management of patients presenting with TLOC, either undifferentiated or thought to be of syncopal origin, have been produced.
However, very little is currently known about the use of diagnostic algorithms and management of this patient group in EDs across Europe. As a result, the application of guidelines and the management of TLOC by European Society of Emergency Medicine (EUSEM) members in different countries and hospitals, cannot yet be recommended for use in settings other than those where they have been successfully validated.
This study aims to describe the prevalence, clinical presentation, current assessment, management strategies and ESC risk categories of patients presenting with TLOC (undifferentiated or thought to be of syncopal origin) to the ED, and will provide data to help identify the gaps in our knowledge and practice, and areas where further research and development work is required to fully implement European Society of Cardiology (ESC) guidelines within European EDs.
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Data collection | Other | All patients will have a focussed Case Report Form completed collecting routine data describing the prevalence, clinical presentation, assessment, management and ESC risk category of patients, at the time or shortly after the patients ED attendance. |
| Measure | Description | Time Frame |
|---|---|---|
| Participant age | Participant age | Admission |
| Participant gender | Participant gender | Admission |
| Mode of arrival | Mode of arrival | Admission |
| Referral source | Referral source | Admission |
| Presence of any European Society of Cardiology (ESC) syncope high-risk history features | Which European Society of Cardiology syncope high-risk history features are present | Admission |
| ESC high-risk 'past medical history' features | Which European Society of Cardiology syncope high-risk 'past medical history' features are present | Admission |
| Other medical comorbidities | Other medical comorbidities | Admission |
| Rockwood Clinical Frailty Scale score | Rockwood Clinical Frailty Scale is a well validated score ranging from 1 (Very Fit) to 9 (Terminally Ill) with defined descriptions for each category. | Admission |
Not provided
Not provided
Inclusion Criteria:
Exclusion Criteria:
Not provided
Not provided
Not provided
Adults 18 years of age and older presenting to the ED over a two-week period with TLOC, either undifferentiated or thought to be of syncopal origin.
Not provided
| Name | Affiliation | Role |
|---|---|---|
| Matt Reed | University of Edinburgh | Study Chair |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Regional Hospital Durres | Durrës | Albania | ||||
| Regional Hospital Centre "Xh. Kongoli" Elbasan |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 42053083 | Derived | Vaittinada Ayar P, Kearns D, Vaittinada Ayar P, Laribi S. Effect of sex on syncope management in European emergency departments: the European Society for Emergency Medicine Research network Syncope in European Emergency Departments study. Eur J Emerg Med. 2026 Jun 1;33(3):197-202. doi: 10.1097/MEJ.0000000000001294. Epub 2026 Apr 27. No abstract available. | |
| 38015745 |
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
| ESC high risk 'physical examination' factors |
ESC high risk 'physical examination' factors |
| Admission |
| Blood pressure (BP) on admission | First Blood pressure (BP) measure in the Emergency Department in mmHg | Admission |
| Pulse rate on admission | First pulse rate measured in the Emergency Department in beats per minute | Admission |
| Lying/standing systolic BP difference on admission | First lying/standing systolic BP difference measured in the Emergency Department in mmHg | Admission |
| Number of participants with abnormal Electrocardiogram (ECG) readings | Number of participants with abnormal ECG readings | Admission |
| Troponin levels | Troponin levels | Admission |
| D-dimer levels | D-dimer levels | Admission |
| Copeptin levels | Copeptin levels | Admission |
| Natriuretic peptides levels | Natriuretic peptides levels | Admission |
| ED clinician diagnosis | ED clinician diagnosis - descriptive | Admission |
| Patient destination | Descriptive options: Admitted to Observation/Clinical Decision Unit/Same Day Emergency Care unit/hospital floor with telemetry monitoring/hospital floor with no telemetry monitoring. Discharged to outpatient follow up/family doctor/General Practitioner care/home with no follow up | Admission |
| Reason(s) for admission | Reason(s) for admission | Admission |
| Whether driving and occupation advice given | Whether driving and occupation advice given | Admission |
| Status at discharge from hospital | Status at discharge from hospital | 30 days |
| Length of hospital stay in days | Length of hospital stay in days | 30 days |
| Hospital discharge diagnosis | Hospital discharge diagnosis | 30 days |
| Elbasan |
| Albania |
| Spitali "Petro Nako" Sarandra | Sarandë | Albania |
| Regional Hospital Shkoder | Shkoder | Albania |
| University Hospital Centre "Mother Theresa" Tirana | Tirana | Albania |
| Allgemeines Krankenhaus der Stadt Wien/ Universitätskliniken | Vienna | Austria |
| Klinik Donaustadt | Vienna | Austria |
| AZ Sint Jan Brugge | Bruges | Belgium |
| AZ Alma Eeklo | Eeklo | Belgium |
| Ghent University Hospital | Ghent | Belgium |
| Heilig Hartziekenhuis Lier | Lier | Belgium |
| University Hospital Hradec Králové | Králová | Czechia |
| University Hospital Královské Vinohrady | Prague | Czechia |
| Regionshospitalet Gødstrup | Herning | Denmark |
| Nordsjællands Hospital | Hillerød | Denmark |
| Regionshospitalet Randers | Randers | Denmark |
| Sjællands Universitetshospital | Roskilde | Denmark |
| Regionshospitalet Midt | Vildbjerg | Denmark |
| Kanta-Häme Central Hospital | Helsinki | Finland |
| CHU Besançon | Besançon | France |
| CHU Caen | Caen | France |
| CHU Clermond-Ferrand | Clermont-Ferrand | France |
| Medipole | Lyon | France |
| CHU Tours | Tours | France |
| University General Hospital ATTIKON | Athens | Greece |
| General Hospital Venizeleio | Heraklion | Greece |
| AHEPA Univesrity General Hospital of Thessaloniki | Thessaloniki | Greece |
| Semmelweis University Department of Emergency Medicine | Budapest | Hungary |
| ED Azienda Ospedaliera Universitaria di Bologna (Sant'Orsola Hospital) | Bologna | Italy |
| ED Azienda Ospedaliera-universitaria di Catania (San Marco Hospital) | Catania | Italy |
| ED Azienda USL Toscana Centro, Firenze (San Giovanni di Dio Hospital) | Florence | Italy |
| Azienda Ospedaliera di Perugia (Santa Maria Della Misericordia Hospital) | Perugia | Italy |
| ED Azienda Ospedaliera-Universitaria integrata (Borgo Trento Hospital) | Verona | Italy |
| Mater Dei Hospital | Birkirkara | Malta |
| Gozo General Hospital | Victoria | Malta |
| St. Olav's University Hospital | Trondheim | Norway |
| Wroclaw University Hospital | Wroclaw | Poland |
| Cluj Napoca County Emergency Clinical Hospital | Cluj-Napoca | Romania |
| Saint Spiridon County Hospital | Iași | Romania |
| Emergency Center Belgrade, Clinical Centre Belgade | Belgrade | Serbia |
| Clinical Centre of Niš | Niš | Serbia |
| Emergency Department Zaječar, Health Center Zaječar | Zaječar | Serbia |
| Hospital Dr. Balmis | Alicante | Spain |
| Hospital clinic Barcelona | Barcelona | Spain |
| Hospital de Terrassa | Barcelona | Spain |
| Hospital Universitari de Bellvitge | Barcelona | Spain |
| Hospital Universitari de Vic | Barcelona | Spain |
| Gazi University Medical Faculty Department of Emergency Medicine | Ankara | Turkey (Türkiye) |
| Medical Science University Ankara Education and Research Hospital Department of Emergency Medicine | Ankara | Turkey (Türkiye) |
| Karamanoglu Mehmetbey University Karaman Education and Research Hospital Department of Emergency Medicine | Karaman | Turkey (Türkiye) |
| Necmettin Erbakan University Medical Faculty Department of Emergency Medicine | Konya | Turkey (Türkiye) |
| Medical Science University Sanliurfa Mehmet Akif Inan Education and Research Hospital Department of Emergency Medicine | Sanliurfa | Turkey (Türkiye) |
| Royal Infirmary of Edinburgh | Edinburgh | Midlothian | EH16 4SA | United Kingdom |
| University Hospital Coventry & Warwickshire | Coventry | United Kingdom |
| Victoria Hospital | Kirkcaldy | United Kingdom |
| St Johns Hospital, Livingston | Livingston | United Kingdom |
| Royal Preston Hospital | Preston | United Kingdom |
| Reed MJ, Karuranga S, Kearns D, Alawiye S, Clarke B, Mockel M, Karamercan M, Janssens K, Riesgo LG, Torrecilla FM, Golea A, Fernandez Cejas JA, Lupan-Muresan EM, Zaimi E, Nuernberger A, Rennet O, Skjaerbaek C, Polyzogopoulou E, Imecz J, Groff P, Camilleri R, Cimpoesu D, Jovic M, Miro O, Anderson R, Laribi S; SEED investigators. Management of syncope in the Emergency Department: a European prospective cohort study (SEED). Eur J Emerg Med. 2024 Apr 1;31(2):136-146. doi: 10.1097/MEJ.0000000000001101. Epub 2023 Nov 27. |
| ID | Term |
|---|---|
| D013575 | Syncope |
| D004630 | Emergencies |
| ID | Term |
|---|---|
| D014474 | Unconsciousness |
| D003244 | Consciousness Disorders |
| D019954 | Neurobehavioral Manifestations |
| D009461 | Neurologic Manifestations |
| D009422 | Nervous System Diseases |
| D012816 | Signs and Symptoms |
| D013568 | Pathological Conditions, Signs and Symptoms |
| D020969 | Disease Attributes |
| D010335 | Pathologic Processes |
Not provided
Not provided
| ID | Term |
|---|---|
| D003625 | Data Collection |
| ID | Term |
|---|---|
| D004812 | Epidemiologic Methods |
| D008919 | Investigative Techniques |
| D017531 | Health Care Evaluation Mechanisms |
| D011787 | Quality of Health Care |
| D017530 | Health Care Quality, Access, and Evaluation |
| D011634 | Public Health |
| D004778 | Environment and Public Health |
Not provided
Not provided