• Am J Emerg Med · May 2019

    Multicenter Study Observational Study

    Recurrent syncope is not an independent risk predictor for future syncopal events or adverse outcomes.

    • Anna Marie Chang, Judd E Hollander, Erica Su, Robert E Weiss, Annick N Yagapen, Susan E Malveau, David H Adler, Aveh Bastani, Christopher W Baugh, Jeffrey M Caterino, Carol L Clark, Deborah B Diercks, Bret A Nicks, Daniel K Nishijima, Manish N Shah, Kirk A Stiffler, Alan B Storrow, Scott T Wilber, and Benjamin C Sun.
    • Department of Emergency Medicine, Thomas Jefferson University Hospital, Philadelphia, PA, United States of America. Electronic address: anna.m.chang@jefferson.edu.
    • Am J Emerg Med. 2019 May 1; 37 (5): 869872869-872.

    UnlabelledAlmost 20% of patients with syncope will experience another event. It is unknown whether recurrent syncope is a marker for a higher or lower risk etiology of syncope. The goal of this study is to determine whether older adults with recurrent syncope have a higher likelihood of 30-day serious clinical events than patients experiencing their first episode.MethodsThis study is a pre-specified secondary analysis of a multicenter prospective, observational study conducted at 11 emergency departments in the US. Adults 60 years or older who presented with syncope or near syncope were enrolled. The primary outcome was occurrence of 30-day serious outcome. The secondary outcome was 30-day serious cardiac arrhythmia. In multivariate analysis, we assessed whether prior syncope was an independent predictor of 30-day serious events.ResultsThe study cohort included 3580 patients: 1281 (35.8%) had prior syncope and 2299 (64.2%) were presenting with first episode of syncope. 498 (13.9%) patients had 1 prior episode while 771 (21.5%) had >1 prior episode. Those with recurrent syncope were more likely to have congestive heart failure, coronary artery disease, previous diagnosis of arrhythmia, and an abnormal ECG. Overall, 657 (18.4%) of the cohort had a serious outcome by 30 days after index ED visit. In multivariate analysis, we found no significant difference in risk of events (adjusted odds ratio 1.09; 95% confidence interval 0.90-1.31; p = 0.387).ConclusionIn older adults with syncope, a prior history of syncope within the year does not increase the risk for serious 30-day events.Copyright © 2018 Elsevier Inc. All rights reserved.

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