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Updated: Apr 19, 2026
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Tilt Testing with Combined Lower Body Negative Pressure: a "Gold Standard" for Measuring Orthostatic Tolerance
Published on: March 21, 2013
22.2K
Syncope recurrence and mortality: a systematic review
Monica Solbiati1, Giovanni Casazza2, Franca Dipaola3
1Medicina ad Indirizzo Fisiopatologico, Dipartimento di Scienze Biomediche e Cliniche 'L. Sacco', Ospedale 'L. Sacco', Università degli Studi di Milano, Via G.B. Grassi 74, 20157 Milano, Italy monica.solbiati@gmail.com.
Summary
Syncope recurrence increases over time, with a 1-year mortality rate of 8.4%. Short-term adverse events after syncope occur in approximately 9% of patients, highlighting the need for better prognosis understanding.
Area of Science:
- Cardiology
- Emergency Medicine
- Clinical Epidemiology
Background:
- Syncope is a common clinical presentation with heterogeneous reported outcomes.
- Accurate prognosis data is crucial for effective patient management and guiding research.
Purpose of the Study:
- To systematically review and meta-analyze prospective observational studies on syncope prognosis.
- To determine syncope recurrence, mortality, and adverse event rates.
Main Methods:
- Systematic literature review of prospective observational studies.
- Inclusion of consecutive patients presenting with syncope to Emergency Departments.
- Meta-analysis using random effects model to pool event rates and 95% confidence intervals (CI).
Main Results:
- Twenty-five studies with 11,158 patients were analyzed.
- Syncope relapse incidence increased linearly to 22% at 2 years.
- Pooled 1-year mortality was 8.4% (95% CI: 6.7-10.2%); short-term composite morbidity/mortality was 9.1% (95% CI: 6.6-12.5%).
Conclusions:
- Syncope prognosis shows a progressive decrease in asymptomatic status over time.
- Short-term mortality (<30 days) is less than 2%, with a ~9% composite endpoint rate at 10 days.
- Understanding syncope prognosis aids clinical decision-making and future study design.
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