Early and late outcome of treated patients referred for syncope to emergency department: The EGSYS 2 follow-up study

Andrea Ungar, Attilio Del Rosso, Franco Giada, Angelo Bartoletti, Raffaello Furlan, Fabio Quartieri, Alfonso Lagi, Alessandro Morrione, Chiara Mussi, Maurizio Lunati, Giuseppe De Marchi, Tiziana De Santo, Niccolò Marchionni, Michele Brignole

Research output: Contribution to journalArticlepeer-review


Aims We evaluated the early (1 month) and late (2 years) death rate and syncopal relapses of patients referred for syncope to 11 general hospitals emergency departments. Patients were enrolled in the Evaluation of Guidelines in SYncope Study 2 (EGSYS 2) study. The guidelines of the European Society of Cardiology were strictly followed in the management of patients. Methods and results Out of the 465 patients enrolled in the EGSYS 2 study, 398 (86) underwent a complete follow-up. We excluded 18 patients with non-syncopal attacks. Among the remaining 380 patients, death of any cause occurred in 35 (9.2). The mean follow-up was 614 ± 73 days. Six deaths (17 of total) occurred during the first month of follow-up. Patients who died were older, had a higher incidence of structural heart disease and/or abnormal ECG, had injuries related to syncope and higher EGSYS score. Syncope recurred in 63 (16.5) patients. Syncopal relapses occurred in only one patient during the first month of follow-up. The incidence of syncopal recurrences was unrelated to the mechanism of syncope. No clinical differences were found between patients with or without syncopal recurrence and in patients with EGSYS score <or ≥3. Conclusion A peak of cardiovascular mortality but not of syncopal recurrences was observed in patients attending to the emergency department for syncope within the first month. Late unfavourable outcomes were caused by associated cardiovascular diseases rather than by the mechanism of syncope. The causes of syncope did not determine the recurrence rate.

Original languageEnglish
Pages (from-to)2021-2026
Number of pages6
JournalEuropean Heart Journal
Issue number16
Publication statusPublished - Aug 2010


  • Diagnosis
  • Emergency department
  • Prognosis
  • Syncope
  • Therapy

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine


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