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Cited by 65Cardiovascular Syncope and Autonomic DisordersBalance, Gait, and Falls PreventionVestibular and auditory disorders

Role of early symptoms in assessment of syncope in elderly people: results from the Italian group for the study of syncope in the elderly

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Galizia, Galizia, Abete, Pasquale, Mussi, Chiara, Noro, Gabriele, Morrione, Alessandro, Langellotto, Assunta, Landi, Annalisa, Cacciatore, Francesco +4 more·2009·Journal of the American Geriatrics Society
DOI 10.1111/j.1532-5415.2008.02070.x
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Abstract

OBJECTIVES: To assess the ability of specific early symptoms to predict cardiac and noncardiac syncope in elderly people. DESIGN: Multicenter cross-sectional observational study. SETTING: Inpatient geriatric acute care departments and outpatient clinics. PARTICIPANTS: Two hundred forty-two patients with syncope (mean age 79+/-8) consecutively referred for evaluation of transient loss of consciousness to any of six clinical centers participating in the Italian Group for the Study of Syncope in the Elderly (GIS Study). MEASUREMENTS: All patients were assessed according to European Society of Cardiology Syncope guidelines and interviewed about symptoms and signs present before syncope. RESULTS: One hundred seventy-four of 242 patients (75.4%) had noncardiac syncope, and 34 (14.7%) had cardiac syncope; 165 patients (71.1%) related symptoms before the loss of consciousness. When elderly patients with syncope were stratified for the presence and absence of symptoms, noncardiac syncope showed the highest prevalence of symptoms (75.3%, P<.01). Awareness of being about to faint, sweating, blurred vision, and nausea are more prevalent in noncardiac syncope. Dyspnea is more prevalent in cardiac syncope. All symptoms except awareness of being about to faint and weakness had good specificity, but sensitivity was low for all symptoms considered. Multivariate regression analysis adjusted for sex and age indicated that nausea (relative risk (RR)=3.7, 95% confidence interval (CI)=1.26-11.2), blurred vision (RR=3.5, 95% CI=1.34-9.59), and sweating (RR=2.8, 95% CI=.21-6.89) were predictive of noncardiac syncope. Dyspnea (RR=5.5, 95% CI=1.0-30.2) was the only symptom predictive of cardiac syncope. CONCLUSION: The data show that symptoms such as nausea, blurred vision, and sweating are predictive of noncardiac syncope, whereas only dyspnea is predictive of cardiac syncope in elderly people.

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Authors
Galizia, G., Abete, P., Mussi, C., Noro, G., Morrione, A., Langellotto, A., Landi, A., Cacciatore, F., Masotti, G., Rengo, F., Marchionni, N., & Ungar, A.
Affiliations
University of Modena and Reggio Emilia (IT)
ORCID
Venue
Journal of the American Geriatrics Society
Publisher
Wiley
Published
2008-12-31
Volume
57
Issue
1
Pages
18-23
ISSN
  • 0002-8614 (ISSN-L)
  • 1532-5415
DOI
10.1111/j.1532-5415.2008.02070.x
OpenAlex
W2115333349
Cited by
65
References
19
Citations by year
2026: 2 · 2025: 1 · 2024: 3 · 2022: 4 · 2021: 5 · 2020: 1 · 2019: 3 · 2018: 5 · 2017: 1 · 2016: 1 · 2015: 2 · 2014: 12 · 2013: 8 · 2012: 6
FWCI
3.49
Type
journal article
Language
en
Open access
Licence
Locations
  • Journal of the American Geriatrics Society (publishedVersion)
  • PubMed (publishedVersion)
  • Florence Research (University of Florence) (submittedVersion)
  • IRIS UNIMORE (University of Modena and Reggio Emilia) (submittedVersion, cc-by)
Funders
European Society of Cardiology
Topics
  • Health Sciences › Medicine › Surgery › Cardiovascular Syncope and Autonomic Disorders
  • Health Sciences › Health Professions › Physical Therapy, Sports Therapy and Rehabilitation › Balance, Gait, and Falls Prevention
  • Life Sciences › Neuroscience › Neurology › Vestibular and auditory disorders
Keywords
syncope, older adults, cardiac syncope, nausea, blurred vision, sweating, dyspnea, transient loss of consciousness, differential diagnosis
MeSH terms
Age Factors, Aged, Aged, 80 and over, Cross-Sectional Studies, Female, Humans, Male, Syncope, Geriatric Assessment

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