Evaluation of outcomes in patients with syncope discharged from the emergency department of Piacenza: a retrospective monocentric study

Despite being commonly encountered in the Emergency Department (ED), syncope remains a diagnostic challenge, particularly among older adults with multimorbidity and polytherapy. The real danger is to underestimate cardiac syncope, which is associated with higher morbidity and mortality. For these reasons, we conducted a retrospective study to evaluate all patients admitted to the ED of Piacenza for syncope or presyncope between 2022 and 2024. Our goal was to investigate the occurrence of Major Adverse Events (MAEs) within 30 days after discharge home. This study aims to assess the effectiveness of our ED protocol for managing syncope, which is based on the 2018 ESC guidelines, which outline three phases that minimize the risk of missed diagnoses while avoiding excessive investigations. Despite being a retrospective monocentric study, the low incidence of MAEs observed supports the protocol’s effectiveness in identifying serious causes of syncope, thus allowing for safe and appropriate management of patients who are discharged home. In the future, the use of artificial intelligence could be useful to confirm the diagnosis, identify high-risk patients and decide the appropriate setting of care (discharge, observation, or admission).