Blanc J-J, L'her C, Gosselin G, Cornily J-C, Fatemi M
Department of Cardiology, Hôpital de la Cavale Blanche, Brest University Hospital, Boulevard Tanguy Prigent, 29609 Brest Cedex, France.
Europace. 2005 Jul;7(4):400-6. doi: 10.1016/j.eupc.2005.03.010.
Management of patients (pts) presenting syncope diverges markedly from the guidelines of the European Society of Cardiology (ESC). To improve this management, the easiest option seemed to be to educate physicians. The aim of the study was to evaluate the impact of an educational process on the use of unnecessary neurological investigations.
Charts of pts presenting syncope during two 12-month periods (1999-2000 and 2002-2003) to the emergency department were systematically reviewed. Between the two periods, all physicians in charge of pts with syncope attended educational meetings. During these meetings recommendations of the ESC were presented with a special emphasis on the uselessness of neurological investigations. Four hundred and fifty-four pts (1.2%) presented to the emergency department for syncope during study period 1, and 524 (1.3%) during study period 2. Nineteen of the 169 pts (11%) directly discharged from the emergency department, had neurological investigations during study period 1 and 22 of the 279 (8%) during study period 2 (NS). In pts who were hospitalized, 48% had neurological investigations in groups 1 and 2.
Education of physicians in charge of patients with syncope is inadequate to improve the cost effectiveness of the management of these patients.
晕厥患者的管理与欧洲心脏病学会（ESC）指南明显不同。为改善这种管理，最简单的选择似乎是对医生进行教育。本研究的目的是评估教育过程对不必要的神经学检查使用情况的影响。
系统回顾了在两个12个月期间（1999 - 2000年和2002 - 2003年）到急诊科就诊的晕厥患者的病历。在这两个时间段之间，所有负责晕厥患者的医生都参加了教育会议。在这些会议上，介绍了ESC的建议，并特别强调了神经学检查的无用性。在研究期1，有454名患者（1.2%）因晕厥到急诊科就诊，在研究期2有524名患者（1.3%）。在研究期1，169名直接从急诊科出院的患者中有19名（11%）进行了神经学检查，在研究期2，279名患者中有22名（8%）进行了神经学检查（无统计学差异）。在住院患者中，第1组和第2组中有48%进行了神经学检查。
对负责晕厥患者的医生进行教育不足以提高这些患者管理的成本效益。
