title: Two-year morbidity and mortality in elderly patients with syncope.
abstract: BACKGROUND
  syncope is a common cause of hospitalisation in the elderly. However, morbidity and mortality in elderly patients with syncope is not well established.
  
  
  METHODS
  two-hundred and forty-two patients older than 65 years consecutively referred to the participating centres for evaluation of transient loss of consciousness were enrolled in a multicentre 2-year longitudinal observational study. Mortality and syncope recurrences were recorded and multidimensionally evaluated at 6, 12, 18 and 24 months.
  
  
  RESULTS
  at 24 months, total mortality was 17.2% and syncope recurrence was 32.5%. Cardiac syncope was more frequent in deceased than in survivor patients (21.7 versus 12.3%; P = 0.03), whereas neuro-mediated (62.1 versus 66.2%; P = 0.357) and unexplained syncope (10.8 versus 11.8%; P = 0.397) did not differ between the two groups. Drug-induced and/or multifactorial syncope was less frequent in patients with syncope recurrence (5.7 versus 10.7%; P = 0.02). Kaplan-Meyer curves indicated that mortality and syncope recurrence increased significantly with age (P = 0.006 and P = 0.008, respectively). At multivariate analysis, mortality was significantly predicted by age and comorbidity (hazard ratios: 1.17 and 1.39, and 95% confidence interval 1.01-1.37 and 1.01-1.93, respectively), and syncope recurrence by age and disability (hazard ratio: 1.13 and 1.04, 95% confidence interval 1.01-1.25 and 1.04-2.25, respectively). Depression increased from baseline to the end of follow-up (from 28.3 to 41.4%; P = 0.001).
  
  
  CONCLUSIONS
  in our patients, mortality was related to increasing age and comorbidity, whereas recurrence was related to increasing age and disability. Cardiac syncope was more frequent in deceased than in survivor patients, and syncope recurrence was high despite a low incidence of unexplained syncope.
authors: Unit of Gerontology and Geriatric Medicine, Department of Critical Care Medicine and Surgery, University of Florence, Italy. aungar@unifi.it
authors: Andrea
authors: A
authors: Ungar
authors: Gianluigi
authors: G
authors: Galizia
authors: Alessandro
authors: A
authors: Morrione
authors: Chiara
authors: C
authors: Mussi
authors: Gabriele
authors: G
authors: Noro
authors: Loredana
authors: L
authors: Ghirelli
authors: Giulio
authors: G
authors: Masotti
authors: Franco
authors: F
authors: Rengo
authors: Niccolò
authors: N
authors: Marchionni
authors: Pasquale
authors: P
authors: Abete
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007558:Italy; D008137:Longitudinal Studies; D008297:Male; D009017:Morbidity; D015999:Multivariate Analysis; D011446:Prospective Studies; D012008:Recurrence; D012189:Retrospective Studies; D015996:Survival Rate; D013575:Syncope / Q000453:epidemiology* / Q000401:mortality*