MiscellaneousIncidence and Influence of Hospitalization for Recurrent Syncope and Its Effect on Short- and Long-Term All-Cause and Cardiovascular Mortality
Section snippets
Methods
In Denmark, all residents have a unique and permanent civil registration number that enables linkage on an individual level among nationwide administrative registries. We identified all patients aged 15 to 90 years who had a first-time diagnosis of syncope (International Classification of Diseases, tenth revision [ICD-10] discharge diagnosis R55.9) from all public hospitals and emergency departments in the period 2001 to 2009. The patients were censored at the end of follow-up (December 31,
Results
We identified a cohort of 70,819 patients with syncope discharged after admission (49%) or discharged directly from emergency department (51%) for first-time syncope. The mean age was 60 ± 20 years, 51% were men, and 38% had a cardiovascular co-morbidity at inclusion in the study (Table 1). During an average follow-up of 3.9 ± 2.6 years, 14,270 patients (20%) with syncope died from all causes, and 7,681 (54%) of these deaths were due to cardiovascular causes. The overall 1-year mortality for
Discussion
In this nationwide cohort of unselected patients hospitalized for first-syncope, we report the incidence of recurrence, the overall prognosis of these patients, and the influence of hospitalization for recurrent syncope on the risk of short- and long-term risk of all-cause death and cardiovascular death. To our knowledge, with the exception of specific cardiac conditions, no other study has investigated the influence of recurrent syncope on the risks of short- and long-term subsequent death.
Disclosures
Dr. Ruwald was supported by unrestricted grants 12-04-R90-A3806-22701 from The Danish Heart Foundation (Copenhagen, Denmark), R108-A104415 from The Lundbeck Foundation (Copenhagen, Denmark), 2012B018 from Helsefonden (Copenhagen, Denmark), Arvid Nilssons Fond (Copenhagen, Denmark), Snedkermester Sophus Jacobsen og Hustru Astrid Jacobsens Fond (Copenhagen, Denmark), and Else og Mogens Wedell-Wedellborgs Fond (Frederikssund, Denmark). The other authors have no conflict of interests related to
References (29)
- et al.
Comparison of incidence, predictors, and the impact of co-morbidity and polypharmacy on the risk of recurrent syncope in patients <85 versus ≥85 years of age
Am J Cardiol
(2013) - et al.
Short- and long-term prognosis of syncope, risk factors, and role of hospital admission: results from the STePS (Short-Term Prognosis of Syncope) study
J Am Coll Cardiol
(2008) - et al.
Syncope predicts the outcome of cardiomyopathy patients: analysis of the SCD-HeFT study
J Am Coll Cardiol
(2008) - et al.
Syncope in advanced heart failure: high risk of sudden death regardless of origin of syncope
J Am Coll Cardiol
(1993) - et al.
Is syncope a risk factor for poor outcomes? Comparison of patients with and without syncope
Am J Med
(1996) - et al.
Prognosis among healthy individuals discharged with a primary diagnosis of syncope
J Am Coll Cardiol
(2013) - et al.
Risk of fatal arrhythmic events in long QT syndrome patients after syncope
J Am Coll Cardiol
(2010) - et al.
Prospective validation of the San Francisco Syncope Rule to predict patients with serious outcomes
Ann Emerg Med
(2006) - et al.
The relation between age, sex, comorbidity, and pharmacotherapy and the risk of syncope: a Danish nationwide study
Europace
(2012) - et al.
Incidence and prognosis of syncope
N Engl J Med
(2002)
Incidence, diagnostic yield and safety of the implantable loop-recorder to detect the mechanism of syncope in patients with and without structural heart disease
Eur Heart J
Pacemaker therapy in patients with neurally mediated syncope and documented asystole: Third International Study on Syncope of Uncertain Etiology (ISSUE-3): a randomized trial
Circulation
Components of clinical trials for vasovagal syncope
Europace
Guidelines for the diagnosis and management of syncope (version 2009)
Eur Heart J
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Arrhythmic risk in single or recurrent episodes of unexplained syncope with complete bundle branch block
2023, Revista Espanola de CardiologiaRecurrent syncope is not an independent risk predictor for future syncopal events or adverse outcomes
2019, American Journal of Emergency MedicineCitation Excerpt :In this cohort of older patients with syncope in the emergency department, we found that over 30% of the population reported having one or more syncopal events in the preceding year. This is higher than previous evaluations of syncope, which has been estimated between 2 and 20% over a lifetime [9,12,13]. This may be due to the older age of our population.
The development and use of a new methodology to reconstruct courses of admission and ambulatory care based on the Danish National Patient Registry
2016, International Journal of Medical InformaticsCitation Excerpt :Full text articles were screened for length of stay calculations or analyses of numbers of (re-)admissions). These studies were either done using the DNPR as it is, with the contacts as equivalents to admissions and courses of ambulatory care [11–19], or with a loosely specified algorithm to create courses of admission [20–22]. This variety of practices makes interpretation of results and comparison with other studies difficult.
Cardiac arrest during recovery after tilt-induced vasodepressor syncope in a 76-year old man
2016, Journal of Acute MedicineCitation Excerpt :Atropine is recommended by current guidelines when cardiac arrest occurs in the operating room due to excessive vagal activity, and if this is the likely cause of the cardiac arrest, 0.5 mg atropine should be given intravenously and cardiopulmonary resuscitation should be started.6 According to recent publications, vasovagal reflexes in early life may predict both mortality and cardiovascular morbidity.7–9 Moreover, frequent syncope independently increases the risk of cerebral white matter lesions.10
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