๊ณ ๋ น ์‘๊ธ‰์‹ค ์‹ค์‹  / Syncope in older emergency department patients

์ •์˜

๊ณ ๋ น ์‘๊ธ‰์‹ค ์‹ค์‹ ์€ cardiac cause, medication effect, orthostatic hypotension, occult bleeding ๋“ฑ ๋‹ค์–‘ํ•œ ์›์ธ์ด ์ฆ๊ฐ€ํ•˜๋Š” ์ž„์ƒ ๋ฌธ์ œ์ด๋‹ค.

์ž„์ƒ ํ•ต์‹ฌ

๊ณ ๋ น๊ตฐ์—์„œ๋Š” ์‹ค์‹ ์˜ ์›์ธ ์ŠคํŽ™ํŠธ๋Ÿผ์ด ์ Š์€ ํ™˜์ž์™€ ๋‹ค๋ฅผ ์ˆ˜ ์žˆ๋‹ค. ํ‡ด์› ๊ฐ€๋Šฅํ•œ ์ €์œ„ํ—˜ ๊ณ ๋ น๊ตฐ์„ ์•ˆ์ „ํ•˜๊ฒŒ ์ •์˜ํ•˜๋Š” ๊ฒƒ์ด ์ค‘์š”ํ•˜๋‹ค. ๊ธฐ์กด syncope risk score๊ฐ€ ๊ณ ๋ น๊ตฐ์—์„œ calibration์ด ๋งž๋Š”์ง€ ๊ฒ€์ฆํ•ด์•ผ ํ•œ๋‹ค.

์ง„๋‹จ

Troponin, BNP, ECG abnormality๊ฐ€ ๊ณ ๋ น syncope์—์„œ ์–ด๋–ค ์˜ˆ์ธก ๊ฐ€์น˜๋ฅผ ๊ฐ€์ง€๋Š”์ง€ ํ‰๊ฐ€ํ•  ์ˆ˜ ์žˆ๋‹ค. ๊ธฐ์กด risk score์˜ ์„ฑ๋Šฅ ๊ฒ€์ฆ๊ณผ age-adapted disposition model ๊ฐœ๋ฐœ์ด ์—ฐ๊ตฌ ์ถ•์ด ๋œ๋‹ค.

์น˜๋ฃŒ

๋ชฉํ‘œ๋Š” admission decision์„ ๊ณผ์†Œํ‰๊ฐ€ํ•˜์ง€ ์•Š์œผ๋ฉด์„œ๋„ ๋ถˆํ•„์š”ํ•œ ์ž…์›์„ ์ค„์ด๋Š” ๊ณ ๋ น ๋งž์ถคํ˜• disposition pathway๋ฅผ ๋งŒ๋“œ๋Š” ๊ฒƒ์ด๋‹ค.

์ถœ์ฒ˜

ESC syncope guideline, ACEP syncope policy๊ฐ€ raw ์ž๋ฃŒ์—์„œ ์–ธ๊ธ‰๋˜์—ˆ๋‹ค.

๐ŸŒฑ ์ถœ์ฒ˜ raw


๋ณธ ๋ฌธ์„œ๋Š” ํ•™์Šตยท์ฐธ๊ณ ์šฉ์ด๋ฉฐ ์‹ค์ œ ์ง„๋ฃŒ ๊ฒฐ์ •์€ ์ž„์ƒ์˜์˜ ํŒ๋‹จ์ž…๋‹ˆ๋‹ค.