In patients presenting to the emergency department with syncope, what is the prevalence of pulmonary embolism and venous thromboembolism at first evaluation and within 90 days?

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Why is this study important?

Syncope is a common presenting complaint among patients to the emergency department (ED), and pulmonary embolism (PE) is recognized as a cause of syncope, albeit an uncommon one. However, a study of syncope patients admitted to hospital reported that 97/560 (17%) had PE; thereby, suggesting that all syncope patients be investigated for PE as the cause.[1] These results have been viewed with skepticism, and this database study was designed to estimate the actual PE prevalence in unselected patients with syncope presenting to the ED.

Which, if any, threats to validity are most likely to have an impact on the results and how?

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