title: Short- and long-term prognosis of syncope, risk factors, and role of hospital admission: results from the STePS (Short-Term Prognosis of Syncope) study.
abstract: OBJECTIVE
  We sought to assess short- and long-term prognosis of syncope and associated risk factors.
  
  
  BACKGROUND
  Syncope is a common clinical event, but our knowledge of its short-term outcome is largely incomplete. Further, it is unknown whether hospital admission might positively affect a patient's syncope prognosis.
  
  
  METHODS
  We screened 2,775 consecutive subjects who presented for syncope at 4 emergency departments between January and July 2004. Short- and long-term severe outcomes (i.e., death and major therapeutic procedures) and related risk factors were compared in all enrolled patients arrayed according to hospital admission or discharge.
  
  
  RESULTS
  A total of 676 subjects were included in the study. Forty-one subjects (6.1%) experienced severe outcomes (5 deaths, 0.7%; 36 major therapeutic procedures, 5.4%) in the 10 days after presentation. An abnormal electrocardiogram, concomitant trauma, absence of symptoms of impending syncope, and male gender were associated with short-term unfavorable outcomes. Long-term severe outcomes were 9.3% (40 deaths, 6.0%; 22 major therapeutic procedures, 3.3%), and their occurrence was correlated with an age >65 years, history of neoplasms, cerebrovascular diseases, structural heart diseases, and ventricular arrhythmias. Short-term major therapeutic procedures were more common (p < 0.05) in subjects who had been admitted to hospital (13.3%) than in discharged (1.6%), whereas mortality was similar. One-year mortality was greater (p < 0.05) in admitted (14.7%) than in discharged (1.8%) patients.
  
  
  CONCLUSIONS
  Risk factors for short- and long-term adverse outcomes after syncope differed. Hospital admission favorably influenced syncope short term prognosis. Instead, 1-year mortality was unaffected by hospital admission and related to comorbidity.
authors.affiliation: Syncope Unit, Internal Medicine II, L. Sacco Hospital, University of Milan, Milan, Italy.
authors.forename: Giorgio
authors.initials: G
authors.lastname: Costantino
authors.forename: Francesca
authors.initials: F
authors.lastname: Perego
authors.forename: Franca
authors.initials: F
authors.lastname: Dipaola
authors.forename: Marta
authors.initials: M
authors.lastname: Borella
authors.forename: Andrea
authors.initials: A
authors.lastname: Galli
authors.forename: Giulia
authors.initials: G
authors.lastname: Cantoni
authors.forename: Simonetta
authors.initials: S
authors.lastname: Dell'Orto
authors.forename: Simonetta
authors.initials: S
authors.lastname: Dassi
authors.forename: Nicola
authors.initials: N
authors.lastname: Filardo
authors.forename: Pier Giorgio
authors.initials: PG
authors.lastname: Duca
authors.forename: Nicola
authors.initials: N
authors.lastname: Montano
authors.forename: Raffaello
authors.initials: R
authors.lastname: Furlan
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000704:Analysis of Variance; D001145:Arrhythmias, Cardiac / Q000150:complications*; D002318:Cardiovascular Diseases / Q000150:complications; D002423:Cause of Death; D015897:Comorbidity; D005260:Female; D006760:Hospitalization; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D012307:Risk Factors; D013575:Syncope / Q000150:complications* / Q000401:mortality*