Performance of the COMPASS-31 questionnaire with regard to autonomic nervous system testing results and medication use: a prospective study in a real-life setting
Abstract
The aim of this study was to investigate the performance of the Composite Autonomic System Score-31 (COMPASS-31) questionnaire in a real-life setting in consecutive patients referred to the laboratory for objective testing of the autonomic nervous system (ANS), with the hypothesis that COMPASS-31 results differ depending on medications and findings of the tilt table test results. One hundred seventy-one consecutive patients (125 females, mean age 41.5 ± 19.3) referred for testing of the ANS were enrolled. Before testing, all patients completed the recently validated Croatian version of COMPASS-31. The following data were systematically collected for all patients: age, sex, diagnoses, and medications. Results of COMPASS-31 were significantly higher in patients taking medications with a known influence on the ANS (p < 0.001). Patients with postural orthostatic tachycardia had significantly higher orthostatic intolerance and vasomotor domains of COMPASS-31 (p = 0.048 and p = 0.022, respectively). Patients with a cardiovagal score ≥ 1 had a significantly higher vasomotor domain of COMPASS-31 compared to patients with normal results of ANS tests (p = 0.030). These findings suggest the COMPASS-31 might be a valuable screening tool for autonomic dysfunctions, as it is associated with impaired ANS tests, but usage of medications that modify the ANS should always be taken into account.
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Wider autonomic symptom burden was greater in people with POTS than in those with vasovagal syncope.
“Wider autonomic symptom burden was greater in people with POTS (mean ± SD COMPASS31 score 48.69 ± 10.02–14.54 out of 100 = 48.7 %; ASP 55.21 ± 18.19 out of 160 = 34.5 %) when compared to those with vasovagal syncope (Ruska et al., 2018”
From Self-reported symptom burden in postural orthostatic tachycardia syndrome (POTS): A narrative review of observational and interventional studies (2023) · cites this paper as Ruska et al., 2018
Table 3 (p. 11) shows a higher COMPASS-31 total score for the POTS group than for the vasovagal syncope group (35.15 versus 20.89), supporting the direction of the comparison. The cited paper does not report the quoted mean ± SD values or ASP scores, and its Results (p. 6) identify significant differences for specific COMPASS-31 domains rather than a significant difference in total symptom burden between these two groups. (LLM, conf=0.87)
Experimental — accuracy not yet measuredOrthostatic intolerance symptoms contributed most to differences between POTS and other groups, followed by light sensitivity, pupillomotor function, vasomotor domains and fatigue.
“Orthostatic intolerance symptoms contributed most to differences between POTS and other groups, followed by light sensitivity (Cortez et al., 2020”
From Self-reported symptom burden in postural orthostatic tachycardia syndrome (POTS): A narrative review of observational and interventional studies (2023) · cites this paper as Ruska et al., 2018
The Results (p. 6) report higher orthostatic-intolerance and vasomotor COMPASS-31 scores in patients with POTS than in patients with normal autonomic tests. The paper does not rank which symptoms contributed most to differences between POTS and other groups, and it does not report light sensitivity or fatigue in that comparison. Its Discussion (p. 7) relates pupillomotor scores to the adrenergic index, not to a ranked POTS-group difference. (LLM, conf=0.86)
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- Authors
- Ruška, B., Pavičić, T., Pavlović, I., Junaković, A., Adamec, I., Crnošija, L., Krbot Skorić, M., & Habek, M.
- Affiliations
- University of Zagreb (HR)
- University Hospital Centre Zagreb (HR)
- Corresponding author
- Habek, Mario
- Venue
- Neurological Sciences
- Published
- 2018-08-23
- Volume
- 39
- Issue
- 12
- Pages
- 2079-2084
- ISSN
- 1590-1874 (ISSN-L)
- 1590-3478
- OpenAlex
- W2888567586
- Cited by
- 28
- References
- 17
- Citations by year
- 2026: 7 · 2025: 2 · 2024: 3 · 2023: 8 · 2022: 3 · 2021: 2 · 2020: 2 · 2019: 1
- FWCI
- 1.31
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- www.springer.com/tdm (tdm)
- Locations
- Neurological Sciences (publishedVersion)
- PubMed (publishedVersion)
- Dr Med - University of Zagreb School of Medicine Digital Repository (acceptedVersion)
- Topics
- Health Sciences › Medicine › Surgery › Cardiovascular Syncope and Autonomic Disorders
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Rate Variability and Autonomic Control
- Life Sciences › Neuroscience › Neurology › Vestibular and auditory disorders
- Keywords
- COMPASS-31, autonomic dysfunction, tilt table test, postural orthostatic tachycardia syndrome, orthostatic intolerance, vasomotor symptoms, screening tool, Croatian version
- MeSH terms
- Adult, Autonomic Nervous System, Autonomic Nervous System Diseases, Female, Humans, Male, Middle Aged, Prospective Studies, Surveys and Questionnaires, Severity of Illness Index, Statistics, Nonparametric, Young Adult
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