Older age predicts short-term, serious events after syncope.
OBJECTIVE
To assess the relationship between age and 14-day serious events after an emergency department (ED) visit for syncope.


METHODS
One-year prospective cohort study.


METHODS
Single academic ED.


METHODS
Adult patients with an ED complaint of syncope or near-syncope.


METHODS
Treating physicians prospectively recorded the presence or absence of potential risk factors for serious clinical events. Patients were contacted by telephone at 14 days for a structured interview. A three-physician panel reviewed ED charts, hospital records, and telephone interview forms to identify predefined events. The primary outcome included any 14-day predefined event. A secondary outcome included any 14-day predefined event that was first diagnosed after the initial ED visit. Age was analyzed in 20-year intervals. Multivariate logistic regression controlled for baseline demographic, comorbidity, and electrocardiogram data.


RESULTS
Of 592 eligible patients, 477 (81%) provided informed consent. Follow-up was successfully obtained for 463 (97%) patients. The age range was 18 to 96, and 47% of patients were aged 60 and older. There were 80 (17%) patients who had a 14-day event, including 18 (4%) with a delayed diagnosis. Compared with patients aged 18 to 39, the adjusted odds ratio (OR) of a serious outcome was 2.7 (95% confidence interval (CI)=0.9-8.4) for patient aged 40 to 59, 3.8 (95% CI=1.3-12) for patients aged 60 to 79, and 3.8 (95% CI=1.2-12) for patients aged 80 and older.


CONCLUSIONS
Age of 60 and older is strongly associated with short-term serious events after an ED visit for syncope.
Sun
Benjamin C
BC
Department of Medicine, West Los Angeles Veterans Affairs Medical Center, Los Angeles, CA 90073, USA. bsun@post.harvard.edu
Hoffman
Jerome R
JR
Mangione
Carol M
CM
Mower
William R
WR
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D004562:Electrocardiography; D005260:Female; D006760:Hospitalization; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D018570:Risk Assessment; D013575:Syncope / Q000150:complications*; D013997:Time Factors; D014193:Trauma Centers