Recurrent syncope in elderly patients and tilt test table outcome: the role of comorbidities.
Syncope is a common disorder that can lead to serious consequences in the elderly. Tilt-test is a safe, useful specific tool to investigate recurrent syncope also in the elderly. Comorbidities and medication use, widely present in elderly patients, affecting the hemodynamic response, can influence the tilt-test outcome. The aim of this study was to evaluate the influence of these confounding factors on tilt-test results in elderly patients with recurrent syncope. We included in this study a consecutive group of 87 patients>75 years (82.1+/-4.3 years) with unexplained syncope. They underwent passive upright tilt-test. Heart rate an blood pressure were recorded using non-invasive devices. The patients were classified according to the modified Vasovagal Syncope International Study (VASIS). Comorbidities were measured with the geriatric index of comorbidities (GIC), which is a composite score taking into account both the number of diseases and their severity as measured by Greenfield's IDS. The tilt-test was positive in 22 patients. There were no significant differences in clinical characteristics, and medication use between the tilt-test negative and positive patients, except for the GIC score (1.12+/-0.5 vs. 2.42+/-0.48; p=0.001) and for a reduced number of medications in the former group (5.7+/-3.1 vs. 8.2+/-2.4; p=0.001). This study suggests that comorbidities and the number of medications could influence tilt test outcome.
Vetta
F
F
Israelitic Hospital, Rome, Italy. Francesco.Vetta@uniroma2.it
Ronzoni
S
S
Costarella
M
M
Donadio
C
C
Battista
L
L
Renzulli
G
G
Gentile
G
G
Zuccaro
S M
SM
D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000502:physiology*; D015897:Comorbidity / Q000639:trends*; D015716:Electrocardiography, Ambulatory; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D011379:Prognosis; D012008:Recurrence; D012307:Risk Factors; D013575:Syncope / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology*; D018667:Tilt-Table Test / Q000379:methods*