Clinical factors affecting symptom recurrence in patients with syncope.
OBJECTIVE
Recurrent syncope leads to poor functional status and psychiatric impairment in patients with syncope. The aim of the study was to prospectively analyze the risk factors attributed to syncope recurrence.


METHODS
Between 2009 and 2010, 289 patients with all cause of syncope visited our institution. Syncope recurrences were followed for 1 year by telephone interview every 3 months.


RESULTS
We diagnosed 181 (63%) patients with neurally mediated syncope (NMS), 39 (13%) with orthostatic hypotension, 34 (12%) with cardiac syncope, and 35 (12%) with unexplained syncope. During the 1-year follow-up period, 19 (6.6%) patients suffered recurrent syncope. Kaplan-Meier curves showed that recurrent syncope was observed more often in patients with unexplained syncope compared with those with NMS (p < 0.01), and also observed more often in patients with six previous syncopal episodes compared to those with fewer episodes (p = 0.02). Cox regression analysis showed that the recurrence of syncope was significantly associated with more than six previous syncopal episodes (HR 5.38, 95% CI 1.17-24.71, p = 0.03) and that there was a tendency for association between recurrence of syncope and unexplained syncope (HR 6.13, 95% CI 0.96-39.1, p = 0.05).


CONCLUSIONS
Patients with previous frequent syncopal episodes or unexplained syncope had higher rates of syncope recurrence during the follow up period.
Division of Cardiology, Department of Medicine, Cardiac and Vascular Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Sung Ho
SH
Lee
Bum Soo
BS
Kim
Seung-Jung
SJ
Park
Young Keun
YK
On
June
J
Huh
June Soo
JS
Kim
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D003937:Diagnosis, Differential; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007024:Hypotension, Orthostatic / Q000209:etiology; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012008:Recurrence; D012737:Sex Factors; D013575:Syncope / Q000209:etiology*; D055815:Young Adult