title: Predicting recurrence of vasovagal syncope: a simple risk score for the clinical routine.
abstract: BACKGROUND
  Predictors for recurrence of syncope are lacking in patients with vasovagal syncope. The aim of this study was to identify risk factors for recurrence of syncope and develop a simple prognostic risk score of clinical value.
  
  
  METHODS
  Two hundred seventy-six patients with a history of vasovagal syncope were prospectively followed for 2 years. Diagnosis of vasovagal syncope was based on clinical history and negative standard work-up. Inclusion in the study was independent from the result of the head-up tilt test, which was performed in all cases. Risk factors for syncope recurrence were evaluated by the Cox proportional hazards regression model and implemented in a risk score, which was validated with the log-rank test and an internal cross-validation.
  
  
  RESULTS
  The Cox-regression analysis identified the number of previous syncopal events, history of bronchial asthma, and female gender as predictors for syncope recurrence (all P < 0.05). In contrast, head-up tilt test response had no predictive value (P = 0.881). Developing a risk score, study patients were identified as having high (recurrence rate during 2 years of follow-up: 37.2%), intermediate (24.8%), and low (6.5%) risk for syncope recurrence (receiver operating characteristic [ROC] of score 0.83, P < 0.01; Log-rank test for event-free survival, P < 0.005).
  
  
  CONCLUSIONS
  In patients with vasovagal syncope, risk of recurrence can be stratified and is predictable based on a simple risk score.
authors.affiliation: Department of Cardiology, University Heart Center, Hamburg, Germany. aydin@uke.de
authors.forename: Muhammet A
authors.initials: MA
authors.lastname: Aydin
authors.forename: Renke
authors.initials: R
authors.lastname: Maas
authors.forename: Kai
authors.initials: K
authors.lastname: Mortensen
authors.forename: Tobias
authors.initials: T
authors.lastname: Steinig
authors.forename: Hanno
authors.initials: H
authors.lastname: Klemm
authors.forename: Tim
authors.initials: T
authors.lastname: Risius
authors.forename: Thomas
authors.initials: T
authors.lastname: Meinertz
authors.forename: Stephan
authors.initials: S
authors.lastname: Willems
authors.forename: Carlos A
authors.initials: CA
authors.lastname: Morillo
authors.forename: Rodolfo
authors.initials: R
authors.lastname: Ventura
mesh_terms: D000328:Adult; D000368:Aged; D001249:Asthma / Q000150:complications; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012372:ROC Curve; D012008:Recurrence; D015203:Reproducibility of Results; D018570:Risk Assessment; D012307:Risk Factors; D012737:Sex Factors; D019462:Syncope, Vasovagal / Q000175:diagnosis* / Q000209:etiology / Q000628:therapy; D018667:Tilt-Table Test; D013997:Time Factors