Half of all patients with syncope have CT head performed with a yield of 1.2% to 3.8%

More than half of patients with syncope underwent CT head with a diagnostic yield of 1.1 percent to 3.8 percent. That is the conclusion of a study to be published in the May 2019 issue of Academic Emergency Medicine (AEM), a journal of the Society for Academic Emergency Medicine (SAEM).

The lead author of the study J. Alexander Viau, MA, BMBS, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada and the University of Limerick, Limerick, Ireland.

The study results indicate that caution should be exercised against indiscriminate use of computed tomography head in the evaluation of patients with syncope. A few studies identified presence of neurologic deficits as a risk factor for underlying serious intracranial conditions.

The authors recommend future large-scale studies to provide more reliable estimates for diagnostic yield for computed tomography of the head among patients with syncope, to develop a robust prediction tool to guide physicians for optimal use of computed tomography of the head, and to produce expert clinical consensus regarding acceptable miss rate.

Commenting on the study is Benjamin Sun, MD, MPP, professor and chair of the Department of Emergency Medicine in the Perelman School of Medicine at the University Pennsylvania and Senior Fellow, Leonard Davis Institute of Health Economics:

"The findings of this study are consistent with the 2017 AHA/ ACC Syncope Guideline Recommendations: CT of the head is not recommended in the routine evaluation of patients with syncope in the absence of focal neurological findings or head injury that support further evaluation."