Two-year morbidity and mortality in elderly patients with syncope

Andrea Ungar, Gianluigi Galizia, Alessandro Morrione, Chiara Mussi, Gabriele Noro, Loredana Ghirelli, Giulio Masotti, Franco Rengo, Niccolò Marchionni, Pasquale Abete

Research output: Contribution to journalArticle

25 Citations (Scopus)

Abstract

Background: Syncope is a common cause of hospitalisation in the elderly. However, morbidity and mortality in elderly patients with syncope is not well established. Methods: two-hundred and forty-two patients older than 65 years consecutively referred to the participating centres for evaluation of transient loss of consciousness were enrolled in a multicentre 2-year longitudinal observational study. Mortality and syncope recurrences were recorded and multidimensionally evaluated at 6, 12, 18 and 24 months. Findings: at 24 months, total mortality was 17.2% and syncope recurrence was 32.5%. Cardiac syncope was more frequent in deceased than in survivor patients (21.7 versus 12.3%; P = 0.03), whereas neuro-mediated (62.1 versus 66.2%; P = 0.357) and unexplained syncope (10.8 versus 11.8%; P = 0.397) did not differ between the two groups. Drug-induced and/or multifactorial syncope was less frequent in patients with syncope recurrence (5.7 versus 10.7%; P = 0.02). Kaplan- Meyer curves indicated that mortality and syncope recurrence increased significantly with age (P = 0.006 and P = 0.008, respectively). At multivariate analysis, mortality was significantly predicted by age and comorbidity (hazard ratios: 1.17 and 1.39, and 95% confidence interval 1.01-1.37 and 1.01-1.93, respectively), and syncope recurrence by age and disability (hazard ratio: 1.13 and 1.04, 95% confidence interval 1.01-1.25 and 1.04-2.25, respectively). Depression increased from baseline to the end of follow-up (from 28.3 to 41.4%; P = 0.001). Conclusions: in our patients, mortality was related to increasing age and comorbidity, whereas recurrence was related to increasing age and disability. Cardiac syncope was more frequent in deceased than in survivor patients, and syncope recurrence was high despite a low incidence of unexplained syncope.

Original languageEnglish
Article numberafr109
Pages (from-to)696-702
Number of pages7
JournalAge and Ageing
Volume40
Issue number6
DOIs
Publication statusPublished - Nov 2011

Fingerprint

Syncope
Morbidity
Mortality
Recurrence
Survivors
Comorbidity
Confidence Intervals
Unconsciousness
Observational Studies
Longitudinal Studies
Hospitalization
Multivariate Analysis

Keywords

  • Elderly
  • Mortality
  • Syncope

ASJC Scopus subject areas

  • Ageing
  • Geriatrics and Gerontology

Cite this

Ungar, A., Galizia, G., Morrione, A., Mussi, C., Noro, G., Ghirelli, L., ... Abete, P. (2011). Two-year morbidity and mortality in elderly patients with syncope. Age and Ageing, 40(6), 696-702. [afr109]. https://doi.org/10.1093/ageing/afr109

Two-year morbidity and mortality in elderly patients with syncope. / Ungar, Andrea; Galizia, Gianluigi; Morrione, Alessandro; Mussi, Chiara; Noro, Gabriele; Ghirelli, Loredana; Masotti, Giulio; Rengo, Franco; Marchionni, Niccolò; Abete, Pasquale.

In: Age and Ageing, Vol. 40, No. 6, afr109, 11.2011, p. 696-702.

Research output: Contribution to journalArticle

Ungar, A, Galizia, G, Morrione, A, Mussi, C, Noro, G, Ghirelli, L, Masotti, G, Rengo, F, Marchionni, N & Abete, P 2011, 'Two-year morbidity and mortality in elderly patients with syncope', Age and Ageing, vol. 40, no. 6, afr109, pp. 696-702. https://doi.org/10.1093/ageing/afr109
Ungar A, Galizia G, Morrione A, Mussi C, Noro G, Ghirelli L et al. Two-year morbidity and mortality in elderly patients with syncope. Age and Ageing. 2011 Nov;40(6):696-702. afr109. https://doi.org/10.1093/ageing/afr109
Ungar, Andrea ; Galizia, Gianluigi ; Morrione, Alessandro ; Mussi, Chiara ; Noro, Gabriele ; Ghirelli, Loredana ; Masotti, Giulio ; Rengo, Franco ; Marchionni, Niccolò ; Abete, Pasquale. / Two-year morbidity and mortality in elderly patients with syncope. In: Age and Ageing. 2011 ; Vol. 40, No. 6. pp. 696-702.
@article{9399b041623f4c2dbcc3db7ad6f8220c,
title = "Two-year morbidity and mortality in elderly patients with syncope",
abstract = "Background: Syncope is a common cause of hospitalisation in the elderly. However, morbidity and mortality in elderly patients with syncope is not well established. Methods: two-hundred and forty-two patients older than 65 years consecutively referred to the participating centres for evaluation of transient loss of consciousness were enrolled in a multicentre 2-year longitudinal observational study. Mortality and syncope recurrences were recorded and multidimensionally evaluated at 6, 12, 18 and 24 months. Findings: at 24 months, total mortality was 17.2{\%} and syncope recurrence was 32.5{\%}. Cardiac syncope was more frequent in deceased than in survivor patients (21.7 versus 12.3{\%}; P = 0.03), whereas neuro-mediated (62.1 versus 66.2{\%}; P = 0.357) and unexplained syncope (10.8 versus 11.8{\%}; P = 0.397) did not differ between the two groups. Drug-induced and/or multifactorial syncope was less frequent in patients with syncope recurrence (5.7 versus 10.7{\%}; P = 0.02). Kaplan- Meyer curves indicated that mortality and syncope recurrence increased significantly with age (P = 0.006 and P = 0.008, respectively). At multivariate analysis, mortality was significantly predicted by age and comorbidity (hazard ratios: 1.17 and 1.39, and 95{\%} confidence interval 1.01-1.37 and 1.01-1.93, respectively), and syncope recurrence by age and disability (hazard ratio: 1.13 and 1.04, 95{\%} confidence interval 1.01-1.25 and 1.04-2.25, respectively). Depression increased from baseline to the end of follow-up (from 28.3 to 41.4{\%}; P = 0.001). Conclusions: in our patients, mortality was related to increasing age and comorbidity, whereas recurrence was related to increasing age and disability. Cardiac syncope was more frequent in deceased than in survivor patients, and syncope recurrence was high despite a low incidence of unexplained syncope.",
keywords = "Elderly, Mortality, Syncope",
author = "Andrea Ungar and Gianluigi Galizia and Alessandro Morrione and Chiara Mussi and Gabriele Noro and Loredana Ghirelli and Giulio Masotti and Franco Rengo and Niccol{\`o} Marchionni and Pasquale Abete",
year = "2011",
month = "11",
doi = "10.1093/ageing/afr109",
language = "English",
volume = "40",
pages = "696--702",
journal = "Age and Ageing",
issn = "0002-0729",
publisher = "Oxford University Press",
number = "6",

}

TY - JOUR

T1 - Two-year morbidity and mortality in elderly patients with syncope

AU - Ungar, Andrea

AU - Galizia, Gianluigi

AU - Morrione, Alessandro

AU - Mussi, Chiara

AU - Noro, Gabriele

AU - Ghirelli, Loredana

AU - Masotti, Giulio

AU - Rengo, Franco

AU - Marchionni, Niccolò

AU - Abete, Pasquale

PY - 2011/11

Y1 - 2011/11

N2 - Background: Syncope is a common cause of hospitalisation in the elderly. However, morbidity and mortality in elderly patients with syncope is not well established. Methods: two-hundred and forty-two patients older than 65 years consecutively referred to the participating centres for evaluation of transient loss of consciousness were enrolled in a multicentre 2-year longitudinal observational study. Mortality and syncope recurrences were recorded and multidimensionally evaluated at 6, 12, 18 and 24 months. Findings: at 24 months, total mortality was 17.2% and syncope recurrence was 32.5%. Cardiac syncope was more frequent in deceased than in survivor patients (21.7 versus 12.3%; P = 0.03), whereas neuro-mediated (62.1 versus 66.2%; P = 0.357) and unexplained syncope (10.8 versus 11.8%; P = 0.397) did not differ between the two groups. Drug-induced and/or multifactorial syncope was less frequent in patients with syncope recurrence (5.7 versus 10.7%; P = 0.02). Kaplan- Meyer curves indicated that mortality and syncope recurrence increased significantly with age (P = 0.006 and P = 0.008, respectively). At multivariate analysis, mortality was significantly predicted by age and comorbidity (hazard ratios: 1.17 and 1.39, and 95% confidence interval 1.01-1.37 and 1.01-1.93, respectively), and syncope recurrence by age and disability (hazard ratio: 1.13 and 1.04, 95% confidence interval 1.01-1.25 and 1.04-2.25, respectively). Depression increased from baseline to the end of follow-up (from 28.3 to 41.4%; P = 0.001). Conclusions: in our patients, mortality was related to increasing age and comorbidity, whereas recurrence was related to increasing age and disability. Cardiac syncope was more frequent in deceased than in survivor patients, and syncope recurrence was high despite a low incidence of unexplained syncope.

AB - Background: Syncope is a common cause of hospitalisation in the elderly. However, morbidity and mortality in elderly patients with syncope is not well established. Methods: two-hundred and forty-two patients older than 65 years consecutively referred to the participating centres for evaluation of transient loss of consciousness were enrolled in a multicentre 2-year longitudinal observational study. Mortality and syncope recurrences were recorded and multidimensionally evaluated at 6, 12, 18 and 24 months. Findings: at 24 months, total mortality was 17.2% and syncope recurrence was 32.5%. Cardiac syncope was more frequent in deceased than in survivor patients (21.7 versus 12.3%; P = 0.03), whereas neuro-mediated (62.1 versus 66.2%; P = 0.357) and unexplained syncope (10.8 versus 11.8%; P = 0.397) did not differ between the two groups. Drug-induced and/or multifactorial syncope was less frequent in patients with syncope recurrence (5.7 versus 10.7%; P = 0.02). Kaplan- Meyer curves indicated that mortality and syncope recurrence increased significantly with age (P = 0.006 and P = 0.008, respectively). At multivariate analysis, mortality was significantly predicted by age and comorbidity (hazard ratios: 1.17 and 1.39, and 95% confidence interval 1.01-1.37 and 1.01-1.93, respectively), and syncope recurrence by age and disability (hazard ratio: 1.13 and 1.04, 95% confidence interval 1.01-1.25 and 1.04-2.25, respectively). Depression increased from baseline to the end of follow-up (from 28.3 to 41.4%; P = 0.001). Conclusions: in our patients, mortality was related to increasing age and comorbidity, whereas recurrence was related to increasing age and disability. Cardiac syncope was more frequent in deceased than in survivor patients, and syncope recurrence was high despite a low incidence of unexplained syncope.

KW - Elderly

KW - Mortality

KW - Syncope

UR - http://www.scopus.com/inward/record.url?scp=80054958989&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=80054958989&partnerID=8YFLogxK

U2 - 10.1093/ageing/afr109

DO - 10.1093/ageing/afr109

M3 - Article

VL - 40

SP - 696

EP - 702

JO - Age and Ageing

JF - Age and Ageing

SN - 0002-0729

IS - 6

M1 - afr109

ER -