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Syncope: etiology, prognosis, and relationship to age
A Dougnac1, R Gonzalez, A Kychenthal
1Department of Internal Medicine, Hospital Clinico, Pontificia Universidad Catolica de Chile, Santiago.
Aging (Milan, Italy)
|March 1, 1991
Summary
Syncope poses a significant risk in older adults. Cardiovascular causes are frequent, and while diagnosis can be simple, mortality remains high, especially in the elderly.
Area of Science:
- Geriatrics
- Cardiology
- Neurology
Background:
- Syncope is a frequent and challenging issue, particularly in elderly individuals.
- Elderly patients (≥65 years) constituted 68% of the study cohort admitted for syncope.
Purpose of the Study:
- To investigate the etiology, diagnostic strategies, and outcomes of syncope in an acute care hospital setting.
- To assess the lethality of syncope in the elderly population.
Main Methods:
- Retrospective analysis of 146 patients admitted for syncope over a 4-year period.
- Diagnosis primarily based on history, physical examination, resting ECG, and 24-hour cardiac monitoring.
- Advanced investigations like echocardiography, electrophysiologic studies, and EEG used for confirmation.
Main Results:
- A specific etiology was identified in 62% of cases, with cardiovascular origins in 75% of those.
- In-hospital mortality was 2.1%, with a 2-year follow-up mortality of 18.1%.
- Mortality was significantly higher in elderly patients (23.9%) and those with cardiovascular syncope (28.3%).
Conclusions:
- Syncope in the elderly is associated with particularly high mortality.
- A diagnostic approach relying on clinical evaluation and basic tests is effective for most syncope patients.
- The study highlights the need for careful evaluation and management of syncope in older adults.