Resource utilization in the management of young patients with syncope in a combat theater of operations.
Clinical features of young patients presenting with syncope have been underreported.


METHODS
Retrospective review using U.S. Military Health System's Theater Medical Data Store and Joint Medical Workstation identified patients evaluated for syncope from January 2005 to October 2007 while deployed to a combat zone.


RESULTS
We identified 848 patients with syncope. The majority (80.8%) were under the age of 40. The diagnostic yield of the ECG was 2.0%. In those <40 years, there were no head CTs or transthoracic echocardiograms that identified a cause of syncope. There was no difference in evacuation out of theater between those <40 years and those >40 years (10.8% vs. 8.6%, p = 0.08). Patients with a prior episode of syncope were more likely to undergo medical evacuation outside of the combat zone (16.0% vs. 7.7%, p < 0.01).


CONCLUSIONS
Evacuation of those <40 years to facilities with advanced imaging did not add diagnostic information.
Bolles
Jonathan A
JA
Brooke Army Medical Center, 3851 Roger Brooke Drive, Fort Sam Houston, TX 78234, USA.
Gentlesk
Philip J
PJ
Lewis
Paul C
PC
Ross
Ronald D
RD
Eckart
Robert E
RE
D000328:Adult; D000367:Age Factors; D004562:Electrocardiography; D005260:Female; D006295:Health Resources / Q000706:statistics & numerical data*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D008887:Military Medicine / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D012307:Risk Factors; D013575:Syncope / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology; D019462:Syncope, Vasovagal / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology; D014481:United States / Q000453:epidemiology; D014857:Warfare