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Nervenheilkunde 2022; 41(07/08): 480-485
DOI: 10.1055/a-1844-8266
Schwerpunkt

Synkopeneinheiten

Synkopenversorgung geriatrischer Patienten aus kardiologischer PerspektiveSyncope unitsManagement of syncope in geriatric patients from a cardiologists’ perspective
Daniel Schick
1   Medizinische Klinik I für Kardiologie, Angiologie und Internistische Intensivmedizin, Uniklinik RWTH Aachen AöR
,
Andreas Napp
1   Medizinische Klinik I für Kardiologie, Angiologie und Internistische Intensivmedizin, Uniklinik RWTH Aachen AöR
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ZUSAMMENFASSUNG

Die Synkopenversorgung bei geriatrischen Patienten ist häufig aufgrund der höheren Wahrscheinlichkeit für schwerwiegende Grunderkrankungen sowie dem Vorliegen von Begleiterkrankungen und Polypharmazie anspruchsvoll. Häufig erfolgt eine stationäre Aufnahme zur weiteren Abklärung mit konsekutiv hohen Kosten für das Gesundheitssystem und ohne verbessertem Outcome für die Patienten. Zur spezifischen diagnostischen Abklärung, Risikostratifizierung und raschen Therapieinitiierung haben sich insbesondere für Intermediär- und Hochrisikosynkopen interdisziplinäre Synkopeneinheiten bewährt. Diese bestehen aus ärztlichen und pflegerischen Synkopenspezialisten sowie einem multidisziplinären Team und können anhand standardisierter Behandlungsalgorithmen eine rasche Diagnostik und ein optimiertes Management gewährleisten. Stationäre Aufnahmen, Aufenthaltsdauer sowie Behandlungskosten konnten hierdurch um 77 %, 50 % bzw. 29 % reduziert werden. Trotz einer klaren Empfehlung der European Society of Cardiology (ESC), haben 88 % der europäischen Krankenhäuser heute weiterhin keinen Zugriff auf eine Synkopeneinheit.

ABSTRACT

The investigation and management of loss of consciousness in older patients is challenging due to the higher rate of co-morbidity and polypharmacy and the greater likelihood of underlying serious pathology. As a result, further assessment is commonly undertaken on an in-patient basis, which increases overall costs whilst not clearly improving patient-orientated outcomes. Multi-disciplinary syncope units consisting of a team including a physician, nurse, and other key allied health professionals with experience in syncope, working according to an approved and evidence-based protocol, have been shown to achieve a diagnosis, risk stratify and initiate therapy more rapidly in patients at intermediate and higher risk. Such units can achieve reductions in hospitalizations, length of stay and costs by 77 %, 50 %, 29 %, respectively. Despite clear recommendations from European Society of Cardiology (ESC), 88 % of European hospitals nowadays still do not have access to a syncope unit.

Schlüsselwörter

Geriatrie - Synkopeneinheit - Risikostratifizierung

Key words

Geriatric - syncope unit - risk stratification


Publication History

Article published online:
28 July 2022

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