title: Syncope recurrence and mortality: a systematic review.
abstract: OBJECTIVE
  Data on adverse events and death rates following syncope are heterogeneous among studies, and knowledge of syncope prognosis could help to better define the correct management of patients.
  
  
  RESULTS
  We performed a systematic review of literature by searching for prospective observational studies enrolling consecutive patients presenting to the Emergency Department because of syncope. The outcomes considered were syncope recurrence and short- and long-term mortality. Morbidity and a composite of morbidity and mortality were also assessed. Pooled event rates and 95% confidence intervals (CI) were calculated for each outcome using the random effects model. Twenty-five studies (11 158 patients) were included. The incidence of syncope relapse linearly increased from 0.3% at 30 days to 22% at 2 years follow-up. One-year mortality rate varied between 5.7 and 15.5%; the pooled estimate was 8.4% (95% CI: 6.7-10.2%). The incidence of adverse events (morbidity) varied between 6.1 and 25.2% at 10 days and 2 years, respectively. The short-term (10 days) pooled incidence of the composite of morbidity and mortality was 9.1% (95% CI: 6.6-12.5%). We found a high statistical heterogeneity between studies.
  
  
  CONCLUSIONS
  This meta-analysis of prospective observational studies shows that the chance of being asymptomatic linearly progressively decreased over time after the first syncope. Short-term (10-30 days) mortality after syncope was <2% and that the overall 10-day rate of the composite endpoint of death and major events was ∼9%. The knowledge of syncope prognosis could help clinicians to understand syncope patients' prognosis and researchers to design future studies.
authors.affiliation: Medicina ad Indirizzo Fisiopatologico, Dipartimento di Scienze Biomediche e Cliniche 'L. Sacco', Ospedale 'L. Sacco', Università degli Studi di Milano, Via G.B. Grassi 74, 20157 Milano, Italy monica.solbiati@gmail.com.
authors.forename: Monica
authors.initials: M
authors.lastname: Solbiati
authors.affiliation: Dipartimento di Scienze Biomediche e Cliniche 'L. Sacco', Università degli Studi di Milano, Via G.B. Grassi 74, 20157 Milano, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Casazza
authors.affiliation: Medicina Interna, Dipartimento di Biotecnologie Mediche e Medicina Traslazionale, Humanitas Clinical and Research Center, Università degli Studi di Milano, Via A. Manzoni, 56, Rozzano, 20089 Milano, Italy.
authors.forename: Franca
authors.initials: F
authors.lastname: Dipaola
authors.affiliation: Medicina ad Indirizzo Fisiopatologico, Dipartimento di Scienze Biomediche e Cliniche 'L. Sacco', Ospedale 'L. Sacco', Università degli Studi di Milano, Via G.B. Grassi 74, 20157 Milano, Italy.
authors.forename: Anna Maria
authors.initials: AM
authors.lastname: Rusconi
authors.affiliation: Medicina ad Indirizzo Fisiopatologico, Dipartimento di Scienze Biomediche e Cliniche 'L. Sacco', Ospedale 'L. Sacco', Università degli Studi di Milano, Via G.B. Grassi 74, 20157 Milano, Italy.
authors.forename: Giulia
authors.initials: G
authors.lastname: Cernuschi
authors.affiliation: Medicina Interna, Dipartimento di Biotecnologie Mediche e Medicina Traslazionale, Humanitas Clinical and Research Center, Università degli Studi di Milano, Via A. Manzoni, 56, Rozzano, 20089 Milano, Italy.
authors.forename: Franca
authors.initials: F
authors.lastname: Barbic
authors.affiliation: Medicina ad Indirizzo Fisiopatologico, Dipartimento di Scienze Biomediche e Cliniche 'L. Sacco', Ospedale 'L. Sacco', Università degli Studi di Milano, Via G.B. Grassi 74, 20157 Milano, Italy.
authors.forename: Nicola
authors.initials: N
authors.lastname: Montano
authors.affiliation: Libin Cardiovascular Institute of Alberta, University of Calgary, 1403, 29 St NW, Calgary, AB, Canada T2N 2T9.
authors.forename: Robert Stanley
authors.initials: RS
authors.lastname: Sheldon
authors.affiliation: Medicina Interna, Dipartimento di Biotecnologie Mediche e Medicina Traslazionale, Humanitas Clinical and Research Center, Università degli Studi di Milano, Via A. Manzoni, 56, Rozzano, 20089 Milano, Italy.
authors.forename: Raffaello
authors.initials: R
authors.lastname: Furlan
authors.affiliation: Medicina ad Indirizzo Fisiopatologico, Dipartimento di Scienze Biomediche e Cliniche 'L. Sacco', Ospedale 'L. Sacco', Università degli Studi di Milano, Via G.B. Grassi 74, 20157 Milano, Italy.
authors.forename: Giorgio
authors.initials: G
authors.lastname: Costantino
mesh_terms: D006801:Humans; D015994:Incidence; D011379:Prognosis; D012008:Recurrence; D013575:Syncope / Q000453:epidemiology / Q000401:mortality*
keywords: Meta-analysis; Mortality; Prognosis; Recurrence; Syncope; Systematic review