Carotid sinus hypersensitivity is common in patients presenting with hip fracture and unexplained falls.
BACKGROUND
We tried to determine the prevalence of carotid sinus hypersensitivity (CSH) in patients with hip fractures with and without a clear history of an accidental fall.


METHODS
We studied 51 patients hospitalized for a hip fracture and 51 matched controls from our outpatients department. All patients were subjected to a carotid sinus massage in the supine and upright position. Patients were categorized in accidental (Group A) and unexplained (Group B) fallers.


RESULTS
Six of 33 (18.2%) patients in Group A and 12 of 18 (66.7%) patients in Group B (P < 0.001) had a positive response to the carotid sinus massage. Nine controls (17.6%) also demonstrated CSH. Patients in Group B were older (A: 75.5 +/- 8.5 years vs B: 80.1 +/- 5.9 years, P =0.029) and were more likely to have a history of unexplained falls or syncope in the past (A: 0% vs B: 66.7%, P < 0.0001) than individuals in group A. Vasodepressor/mixed forms accounted for the majority of CSH responses in Group B (75%). When compared with the control group, CSH was still more common in Group B (B: 66.7% vs control: 17.6%, P < 0.0001) but not in Group A (A: 18.2% vs control: 17.6%, P =1.000).


CONCLUSIONS
The prevalence of CSH is increased in elderly patients with hip fractures, only in those who present with an unexplained fall and report a history of syncope or unexplained falls in the past. The vasodepressor/mixed forms account for the majority of CSH responses in the group of unexplained fallers.
Sachpekidis
Vasileios
V
2nd Department of Cardiology, Aristotle University, Hippocration Hospital, Thessaloniki, Greece. bsaxpe@yahoo.gr
Vogiatzis
Ioannis
I
Dadous
George
G
Kanonidis
Ioannis
I
Papadopoulos
Constantinos
C
Sakadamis
George
G
D000058:Accidental Falls / Q000706:statistics & numerical data*; D000368:Aged; D000369:Aged, 80 and over; D015897:Comorbidity; D005260:Female; D006115:Greece / Q000453:epidemiology; D006336:Heart Massage / Q000706:statistics & numerical data; D006620:Hip Fractures / Q000453:epidemiology*; D006801:Humans; D015994:Incidence; D008297:Male; D018570:Risk Assessment; D012307:Risk Factors; D013575:Syncope / Q000175:diagnosis* / Q000453:epidemiology*