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Older Age Predicts Short‐Term, Serious Events After Syncope
Author(s) -
Sun Benjamin C.,
Hoffman Jerome R.,
Mangione Carol M.,
Mower William R.
Publication year - 2007
Publication title -
journal of the american geriatrics society
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.992
H-Index - 232
eISSN - 1532-5415
pISSN - 0002-8614
DOI - 10.1111/j.1532-5415.2007.01188.x
Subject(s) - medicine , emergency department , confidence interval , comorbidity , odds ratio , telephone interview , prospective cohort study , logistic regression , syncope (phonology) , pediatrics , multivariate analysis , cohort , cohort study , emergency medicine , social science , psychiatry , sociology
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.