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Evidence-based algorithms and the management of falls and syncope presenting to acute medical services

Steve W Parry, Richard Frearson, Nick Steen, Julia L Newton, Prathiba Tryambake and Rose Anne Kenny
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DOI: https://doi.org/10.7861/clinmedicine.8-2-157
Clin Med April 2008
Steve W Parry
Falls and Syncope Service and Institute for Ageing and Health, Royal Victoria Infirmary, Newcastle upon Tyne
Roles: Clinical Senior Lecturer and Honorary Consultant Physician
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Richard Frearson
Falls and Syncope Service and Institute for Ageing and Health, Royal Victoria Infirmary, Newcastle upon Tyne
Roles: Consultant Physician
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Nick Steen
Institute of Health and Society, University of Newcastle
Roles: Senior Research Associate (Statistics)
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Julia L Newton
Falls and Syncope Service and Institute for Ageing and Health, Royal Victoria Infirmary, Newcastle upon Tyne
Roles: Clinical Senior Lecturer and Honorary Consultant Physician
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Prathiba Tryambake
Falls and Syncope Service and Institute for Ageing and Health, Royal Victoria Infirmary, Newcastle upon Tyne
Roles: Senior House Officer
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Rose Anne Kenny
Trinity College, Dublin
Roles: Professor of Medicine
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Abstract

Falls and syncope are symptoms that commonly present to medical services. Detailed international guidelines for their management are available but tend to be aimed at specialists rather than generalists. Novel, evidence-based algorithms for the management of these symptoms when they present to acute medical services were formulated and their impact on patient care audited. The percentage of people admitted with falls and syncope was unexpectedly high (10.6% at baseline); this had decreased to 8.2% at repeat audit. Readmission rates decreased from 12% at baseline audit to 0% in repeat audit, while length of inpatient stay was unchanged. Mortality was strikingly high (12%) in both audits. Although inappropriate use of investigations decreased, the use of appropriate management strategies increased. Easy-to-use algorithms can help reduce the number of patients admitted to acute medical services with falls and syncope while optimising the care of those managed as inpatients. The algorithms are provided for use by interested parties.

KEY WORDS
  • aged
  • audit
  • elderly
  • falls
  • guidelines
  • syncope
  • © 2008 Royal College of Physicians
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Evidence-based algorithms and the management of falls and syncope presenting to acute medical services
Steve W Parry, Richard Frearson, Nick Steen, Julia L Newton, Prathiba Tryambake, Rose Anne Kenny
Clinical Medicine Apr 2008, 8 (2) 157-162; DOI: 10.7861/clinmedicine.8-2-157

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Evidence-based algorithms and the management of falls and syncope presenting to acute medical services
Steve W Parry, Richard Frearson, Nick Steen, Julia L Newton, Prathiba Tryambake, Rose Anne Kenny
Clinical Medicine Apr 2008, 8 (2) 157-162; DOI: 10.7861/clinmedicine.8-2-157
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