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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.

Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology
|December 6, 2014
PubMed
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.

Keywords:
Meta-analysisMortalityPrognosisRecurrenceSyncopeSystematic review

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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.