3776 Syncope: the invaluable role of a multidisciplinary team (MDT) in managing complexity

Abstract Introduction Syncope is a common clinical problem[1] posing a diagnostic and therapeutic challenge, due to varied presentations and underlying pathologies[2]. Although an MDT approach is a recognised key component in patient care[3], there is no current guidance in the context of syncope. The Syncope Service in QEUH Glasgow is run by Geriatricians with a specialist interest in Syncope. A formalised monthly MDT, introduced in November 2017, involves Geriatricians, Cardiologists, a Neurologist and Cardiac Physiologists. Method A retrospective case note analysis undertaken for patients reviewed at the Syncope MDT (November 2017–March 2023), assessed the impact on diagnosis, further investigation and treatment initiation. Results 149 patients, with an average age of 65, were discussed at the MDT. The reasons for referral were cardiology specialist advice (62.4%), neurology specialist advice (19.5%) and multi-specialty case review (16.8%). Following discussion, cases of unexplained syncope decreased from 28.9% to 21%. The diagnosis of a cardiac rhythm abnormality increased from 11.4% to 19.5%, and a provisional diagnosis of a seizure disorder increased from 12.8% to a confirmed 14.8%, without the need for additional specialty clinic review. The MDT facilitated prompt access to investigations such as ILR (9.4%) and commencement of appropriate treatment such as anti-epileptic medication (6.6%) or PPM insertion (8.6%). Conclusion By leveraging the collective expertise of diverse healthcare professionals, the syncope MDT enhances diagnostic precision, facilitates comprehensive investigations and streamlines the patient journey. References 1. Chen LY, Shen WK, Mahoney DW. et al. Prevalence of syncope in a population aged more than 45 years. Am J Medi 2006;119:–e1. 2. McLintock B, Reid J, Capek E. et al. Unscheduled care bed days can be reduced with a syncope pathway and rapid access syncope clinic. Br J Cardiol 2019;26:–. 3. McAlister FA, Stewart S, Ferrua S. et al. Multidisciplinary strategies for the management of heart failure patients at high risk for admission: a systematic review of randomised trials. J Am Coll Cardiol 2004;44:–.