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Prognosis Among Healthy Individuals Discharged With a Primary Diagnosis of Syncope
Study Questions:
What is the prognosis of otherwise healthy individuals after a first hospitalization for syncope?
Methods:
A nationwide registry in Denmark was accessed to identify 37,017 individuals (mean age 48 years) with a first-time hospitalization or emergency department (ED) visit for syncope and no comorbidities. Every individual with syncope was matched by age and gender with five control subjects. The primary outcome was all-cause mortality during a mean follow-up of 4.5 years.
Results:
The mortality rate at 1 year did not differ significantly between the syncope group (1.9%) and the control group (2%). Long-term mortality was significantly higher in the syncope group (8.2%) than in the control group (7.7%). A first episode of syncope was an independent predictor of mortality (hazard ratio [HR], 1.06), cardiovascular hospitalization (HR, 1.74), stroke (HR, 1.35), and pacemaker/implantable cardioverter-defibrillator implantation (HR, 5.52).
Conclusions:
A first hospitalization or ED visit for syncope in individuals without comorbidities is a significant predictor of mortality, cardiovascular hospitalization, stroke, and device implantation.
Perspective:
A problem with this study is that the outcomes were not analyzed with respect to the cause of the syncope. It is very likely that the most common cause of syncope, namely vasodepressor (neurocardiogenic) syncope, was not associated with a heightened risk of adverse outcomes.
Keywords: Stroke, Defibrillators, Follow-Up Studies, Denmark, Syncope, Comorbidity, Angioplasty, Prognosis, Registries, Cardiology, Pacemaker, Artificial
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