Syncope recurrence and mortality: A systematic review

Monica Solbiati, Giovanni Casazza, Franca Dipaola, Anna Maria Rusconi, Giulia Cernuschi, Franca Barbic, Nicola Montano, Robert Stanley Sheldon, Raffaello Furlan, Giorgio Costantino

Research output: Contribution to journalArticle

Abstract

Aims 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. Methods and 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. Conclusion 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

Original languageEnglish
Pages (from-to)300-308
Number of pages9
JournalEuropace
Volume17
Issue number2
DOIs
Publication statusPublished - Dec 24 2014

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Keywords

  • Meta-analysis
  • Mortality
  • Prognosis
  • Recurrence
  • Syncope
  • Systematic review

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)
  • Medicine(all)

Cite this

Solbiati, M., Casazza, G., Dipaola, F., Maria Rusconi, A., Cernuschi, G., Barbic, F., Montano, N., Sheldon, R. S., Furlan, R., & Costantino, G. (2014). Syncope recurrence and mortality: A systematic review. Europace, 17(2), 300-308. https://doi.org/10.1093/europace/euu327