Older age predicts short-term, serious events after syncope

Benjamin Sun, Jerome R. Hoffman, Carol M. Mangione, William R. Mower

Research output: Contribution to journalArticle

26 Citations (Scopus)

Abstract

OBJECTIVES: To assess the relationship between age and 14-day serious events after an emergency department (ED) visit for syncope. DESIGN: One-year prospective cohort study. SETTING: Single academic ED. PARTICIPANTS: Adult patients with an ED complaint of syncope or near-syncope. MEASUREMENTS: Treating physicians prospectively recorded the presence or absence of potential risk factors for serious clinical events. Patients were contacted by telephone at 14 days for a structured interview. A three-physician panel reviewed ED charts, hospital records, and telephone interview forms to identify predefined events. The primary outcome included any 14-day predefined event. A secondary outcome included any 14-day predefined event that was first diagnosed after the initial ED visit. Age was analyzed in 20-year intervals. Multivariate logistic regression controlled for baseline demographic, comorbidity, and electrocardiogram data. RESULTS: Of 592 eligible patients, 477 (81%) provided informed consent. Follow-up was successfully obtained for 463 (97%) patients. The age range was 18 to 96, and 47% of patients were aged 60 and older. There were 80 (17%) patients who had a 14-day event, including 18 (4%) with a delayed diagnosis. Compared with patients aged 18 to 39, the adjusted odds ratio (OR) of a serious outcome was 2.7 (95% confidence interval (CI)=0.9-8.4) for patient aged 40 to 59, 3.8 (95% CI=1.3-12) for patients aged 60 to 79, and 3.8 (95% CI=1.2-12) for patients aged 80 and older. CONCLUSION: Age of 60 and older is strongly associated with short-term serious events after an ED visit for syncope.

Original languageEnglish (US)
Pages (from-to)907-912
Number of pages6
JournalJournal of the American Geriatrics Society
Volume55
Issue number6
DOIs
StatePublished - Jun 2007
Externally publishedYes

Fingerprint

Syncope
Hospital Emergency Service
Confidence Intervals
Interviews
Physicians
Hospital Records
Delayed Diagnosis
Informed Consent
Telephone
Comorbidity
Electrocardiography
Cohort Studies
Logistic Models
Odds Ratio
Demography
Prospective Studies

Keywords

  • Prognosis
  • Risk predictors
  • Syncope

ASJC Scopus subject areas

  • Geriatrics and Gerontology

Cite this

Older age predicts short-term, serious events after syncope. / Sun, Benjamin; Hoffman, Jerome R.; Mangione, Carol M.; Mower, William R.

In: Journal of the American Geriatrics Society, Vol. 55, No. 6, 06.2007, p. 907-912.

Research output: Contribution to journalArticle

Sun, Benjamin ; Hoffman, Jerome R. ; Mangione, Carol M. ; Mower, William R. / Older age predicts short-term, serious events after syncope. In: Journal of the American Geriatrics Society. 2007 ; Vol. 55, No. 6. pp. 907-912.
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abstract = "OBJECTIVES: To assess the relationship between age and 14-day serious events after an emergency department (ED) visit for syncope. DESIGN: One-year prospective cohort study. SETTING: Single academic ED. PARTICIPANTS: Adult patients with an ED complaint of syncope or near-syncope. MEASUREMENTS: Treating physicians prospectively recorded the presence or absence of potential risk factors for serious clinical events. Patients were contacted by telephone at 14 days for a structured interview. A three-physician panel reviewed ED charts, hospital records, and telephone interview forms to identify predefined events. The primary outcome included any 14-day predefined event. A secondary outcome included any 14-day predefined event that was first diagnosed after the initial ED visit. Age was analyzed in 20-year intervals. Multivariate logistic regression controlled for baseline demographic, comorbidity, and electrocardiogram data. RESULTS: Of 592 eligible patients, 477 (81{\%}) provided informed consent. Follow-up was successfully obtained for 463 (97{\%}) patients. The age range was 18 to 96, and 47{\%} of patients were aged 60 and older. There were 80 (17{\%}) patients who had a 14-day event, including 18 (4{\%}) with a delayed diagnosis. Compared with patients aged 18 to 39, the adjusted odds ratio (OR) of a serious outcome was 2.7 (95{\%} confidence interval (CI)=0.9-8.4) for patient aged 40 to 59, 3.8 (95{\%} CI=1.3-12) for patients aged 60 to 79, and 3.8 (95{\%} CI=1.2-12) for patients aged 80 and older. CONCLUSION: Age of 60 and older is strongly associated with short-term serious events after an ED visit for syncope.",
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