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Benötigen wir Syncope Units?

Erfahrungsbericht aus Bozen, Südtirol (Italien)
  • Matthias Unterhuber
  • Marco Tomaino
  • Michele Brignole
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Zusammenfassung

Synkopen sind ein häufiges Leitsymptom bei Zugängen in der Notaufnahme. Aufgrund der vielen Differenzialdiagnosen und potenziell lebensbedrohlichen Ursache stellen sie häufig eine Herausforderung für den behandelnden Arzt oder die behandelnde Ärztin dar. Oft resultieren daraus inadäquate stationäre Aufnahmen und damit verbundene Kosten. Mehrere Studien haben gezeigt, dass der Grund dafür ein unstrukturierter und Best-Clinical-Practice-Ansatz im Gegensatz zu einem standardisierten diagnostischen Ablauf ist. Dies hat eine Unterdiagnostizierung bzw. häufig falsche Diagnosen zur Folge. Daraus ergeben sich ungezielte Therapien und häufige Rezidive der Synkopen mit Einschränkung der Lebensqualität und Wiedervorstellungen. Aus diesem Grund wird in den ESC-Leitlinien für das Management der Synkope die Strukturierung in Syncope Units empfohlen. Durch Syncope Units kann mittels standardisierter und evidenzbasierter Abläufe die Abklärung schnell und effektiv gestaltet, ein geordnetes Follow-up und die Patientenbetreuung organisiert werden. Dieser Artikel fasst die Gründe einer Notwendigkeit von Syncope Units zusammen und erläutert die Umsetzung der Leitlinien anhand des Beispiels der Syncope Unit in Bozen, Südtirol (Italien).

Schlüsselwörter

Vorübergehender Bewusstseinsverlust Sturz Neurokardiogene Synkope Leitlinien Fast-track 

Do we need syncope units?

Experience from Bolzano, South Tyrol (Italy)

Abstract

Syncope is a common cause for presentation to the emergency department. Because of the numerous differential diagnoses which can be life-threatening, it can be a challenging work-up for the physician. This often results in admission rates that are too high and hospital stays that are too long with consequent high costs. Several studies have shown the inferiority of best-clinical practice to an evidence-based approach in syncope work-up, which results in underdiagnosis and often incorrect diagnosis of syncope. The consequences are undirected therapies and subsequently high recurrence rates of syncope, which lead to limited quality of life and readmissions. For this reason, the European Society of Cardiology (ESC) Guidelines for the diagnosis and management of syncope recommend the organization of Syncope Units. Through a standardized and evidence-based approach, the diagnostic and therapeutic work-up can be done in a safe and effective manner, allowing an organized follow-up and further management of patients with syncope. This article summarizes the reasons for the need of syncope units and explains the practical implementation of the guidelines using the example of the Syncope Unit in Bolzano, South Tyrol (Italy).

Keywords

Neurocardiogenic syncope Fainting Transient loss of consciousness Guidelines Fast-track 

Notes

Einhaltung ethischer Richtlinien

Interessenkonflikt

M. Unterhuber, M. Tomaino und M. Brignole geben an, dass kein Interessenkonflikt besteht.

Dieser Beitrag beinhaltet keine von den Autoren durchgeführten Studien an Menschen oder Tieren.

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Copyright information

© Springer Medizin Verlag GmbH, ein Teil von Springer Nature 2018

Authors and Affiliations

  • Matthias Unterhuber
    • 1
    • 2
  • Marco Tomaino
    • 2
  • Michele Brignole
    • 3
  1. 1.Herzzentrum LeipzigLeipzigDeutschland
  2. 2.Regionalkrankenhaus BozenBozenItalien
  3. 3.Department of CardiologyOspedali TigullioLavagnaItalien

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