Advertisement

Click here for more guidelines.

 
 




CME Topic Collections Past Issues Search Current Issue Home
     

J Am Coll Cardiol, 2008; 51:276-283, doi:10.1016/j.jacc.2007.08.059
© 2008 by the American College of Cardiology Foundation
This Article
Right arrow Figures Only
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in Web of Science
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Web of Science (15)
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Costantino, G.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Costantino, G.
Related Collections
Right arrowRelated Articles

CLINICAL RESEARCH: HEART RHYTHM DISORDER

Short- and Long-Term Prognosis of Syncope, Risk Factors, and Role of Hospital Admission

Results From the STePS (Short-Term Prognosis of Syncope) Study

Giorgio Costantino, MD*, Francesca Perego, MD*, Franca Dipaola, MD*, Marta Borella, MD*, Andrea Galli, MD*, Giulia Cantoni, MD{dagger}, Simonetta Dell’Orto, MD{ddagger}, Simonetta Dassi, MD§, Nicola Filardo, MD*, Pier Giorgio Duca, MD||, Nicola Montano, MD, PhD*, Raffaello Furlan, MD*,* on behalf of the STePS Investigators

* Syncope Unit, Internal Medicine II, "L. Sacco" Hospital, University of Milan, Milan, Italy
{dagger} Emergency Medicine, "Fatebenefratelli" Hospital, Milan, Italy
{ddagger} Cardiology, "Uboldo" Hospital, Cernusco s. Naviglio, Milan, Italy
§ Internal Medicine, "S. Corona" Hospital, Garbagnate Milanese, Milan, Italy
|| Medical Statistics, Institute of Clinical Science "L.Sacco," University of Milan, Milan, Italy.

Manuscript received April 27, 2007; revised manuscript received August 7, 2007, accepted August 13, 2007.

* Reprint requests and correspondence: Dr. Raffaello Furlan, Unità Sincopi e Disturbi della Postura, Medicina Interna II, Ospedale L. Sacco, Università di Milano, Via G.B. Grassi 74, 20157 Milano, Italy. (Email: raffaello.furlan{at}unimi.it).

Objective: We sought to assess short- and long-term prognosis of syncope and associated risk factors.

Background: Syncope is a common clinical event, but our knowledge of its short-term outcome is largely incomplete. Further, it is unknown whether hospital admission might positively affect a patient’s syncope prognosis.

Methods: We screened 2,775 consecutive subjects who presented for syncope at 4 emergency departments between January and July 2004. Short- and long-term severe outcomes (i.e., death and major therapeutic procedures) and related risk factors were compared in all enrolled patients arrayed according to hospital admission or discharge.

Results: A total of 676 subjects were included in the study. Forty-one subjects (6.1%) experienced severe outcomes (5 deaths, 0.7%; 36 major therapeutic procedures, 5.4%) in the 10 days after presentation. An abnormal electrocardiogram, concomitant trauma, absence of symptoms of impending syncope, and male gender were associated with short-term unfavorable outcomes. Long-term severe outcomes were 9.3% (40 deaths, 6.0%; 22 major therapeutic procedures, 3.3%), and their occurrence was correlated with an age >65 years, history of neoplasms, cerebrovascular diseases, structural heart diseases, and ventricular arrhythmias. Short-term major therapeutic procedures were more common (p < 0.05) in subjects who had been admitted to hospital (13.3%) than in discharged (1.6%), whereas mortality was similar. One-year mortality was greater (p < 0.05) in admitted (14.7%) than in discharged (1.8%) patients.

Conclusions: Risk factors for short- and long-term adverse outcomes after syncope differed. Hospital admission favorably influenced syncope short term prognosis. Instead, 1-year mortality was unaffected by hospital admission and related to comorbidity.

Abbreviations and Acronyms
  CI = confidence interval
  ECG = electrocardiogram/electrocardiographic
  ED = emergency department
  OR = odds ratio


Related Articles

Syncope Management From Emergency Department to Hospital
Michele Brignole and Win K. Shen
J. Am. Coll. Cardiol. 2008 51: 284-287. [Full Text] [PDF]

Inside This Issue of JACC
J. Am. Coll. Cardiol. 2008 51: A37-A38. [Full Text] [PDF]



This article has been cited by other articles:


Home page
EuropaceHome page
M. Daccarett, T. L. Jetter, S. L. Wasmund, M. Brignole, and M. H. Hamdan
Syncope in the emergency department: comparison of standardized admission criteria with clinical practice
Europace, November 1, 2011; 13(11): 1632 - 1638.
[Abstract] [Full Text] [PDF]


Home page
EuropaceHome page
A. Raviele, F. Giada, L. Bergfeldt, J. J. Blanc, C. Blomstrom-Lundqvist, L. Mont, J. M. Morgan, M. J. P. Raatikainen, G. Steinbeck, S. Viskin, et al.
Management of patients with palpitations: a position paper from the European Heart Rhythm Association
Europace, July 1, 2011; 13(7): 920 - 934.
[Full Text] [PDF]


Home page
Eur Heart JHome page
A. Ungar, A. Del Rosso, F. Giada, A. Bartoletti, R. Furlan, F. Quartieri, A. Lagi, A. Morrione, C. Mussi, M. Lunati, et al.
Early and late outcome of treated patients referred for syncope to emergency department: the EGSYS 2 follow-up study
Eur. Heart J., August 2, 2010; 31(16): 2021 - 2026.
[Abstract] [Full Text] [PDF]


Home page
Age AgeingHome page
J. L. Newton, A. Marsh, J. Frith, and S. Parry
Experience of a rapid access blackout service for older people
Age Ageing, March 1, 2010; 39(2): 265 - 268.
[Full Text] [PDF]


Home page
J Am Coll CardiolHome page
M. J. Reed, D. E. Newby, A. J. Coull, R. J. Prescott, K. G. Jacques, and A. J. Gray
The ROSE (Risk Stratification of Syncope in the Emergency Department) Study
J. Am. Coll. Cardiol., February 23, 2010; 55(8): 713 - 721.
[Abstract] [Full Text] [PDF]


Home page
J Am Coll CardiolHome page
D. G. Benditt and I. Can
Initial Evaluation of "Syncope and Collapse": The Need for a Risk Stratification Consensus
J. Am. Coll. Cardiol., February 23, 2010; 55(8): 722 - 724.
[Full Text] [PDF]


Home page
Eur Heart JHome page
Developed in collaboration with, European Heart Rhythm Association (EHRA), Heart Failure Association (HFA), and Heart Rhythm Society (HRS), Endorsed by the following societies, European Society of Emergency Medicine (EuSEM), European Federation of Internal Medicine (EFIM), European Union Geriatric Medicine Society (EUGMS), American Geriatrics Society (AGS), European Neurological Society (ENS), et al.
Guidelines for the diagnosis and management of syncope (version 2009): The Task Force for the Diagnosis and Management of Syncope of the European Society of Cardiology (ESC)
Eur. Heart J., November 1, 2009; 30(21): 2631 - 2671.
[Full Text] [PDF]


Home page
CirculationHome page
D. Sorajja, G. C. Nesbitt, D. O. Hodge, P. A. Low, S. C. Hammill, B. J. Gersh, and W.-K. Shen
Syncope While Driving: Clinical Characteristics, Causes, and Prognosis
Circulation, September 15, 2009; 120(11): 928 - 934.
[Abstract] [Full Text] [PDF]


Home page
Arch Intern MedHome page
J. V. Quinn
Yield of Diagnostic Tests in Evaluating Syncopal Episodes in Older Patients--Invited Commentary
Arch Intern Med, July 27, 2009; 169(14): 1305 - 1306.
[Full Text] [PDF]


Home page
J Am Coll CardiolHome page
D. G. Benditt and J. T. Nguyen
Syncope: Therapeutic Approaches
J. Am. Coll. Cardiol., May 12, 2009; 53(19): 1741 - 1751.
[Abstract] [Full Text] [PDF]


Home page
ESC Textbook of Cardiovascular MedicineHome page
M. Brignole, J.-J. Blanc, R. Sutton, and A. Moya
CHAPTER 26 Syncope
ESC Textbook of Cardiovascular Medicine, January 1, 2009; 2(1): med-9780199566990-chapter - med-9780199566990-chapter.
[Abstract] [Full Text] [PDF]


Home page
J Am Coll CardiolHome page
M. Brignole and W. K. Shen
Syncope Management From Emergency Department to Hospital
J. Am. Coll. Cardiol., January 22, 2008; 51(3): 284 - 287.
[Full Text] [PDF]



 
  CME Topic Collections Past Issues Search Current Issue Home

Advertisement