Mid-Western Regional Hospital (Department of Medicine, Division of Ageing & Therapeutics) & Graduate Entry Medical School, University of Limerick, Limerick, Ireland.
QJM. 2011 Aug;104(8):689-95. doi: 10.1093/qjmed/hcr032. Epub 2011 Mar 7.
Reports of the outcomes of syncope assessment across a broad spectrum of ages in a single population are scarce. It is our objective to chart the varying prevalence of orthostatic and neurocardiogenic syncope (NCS) as a patient ages.
This was a retrospective study. All consecutive patients referred to a tertiary referral syncope unit over a decade were included. Patients were referred with recurrent falls or orthostatic intolerance. Tilt tests and carotid sinus massage (CSM) were performed in accordance with best practice guidelines.
A total of 3002 patients were included (1451 short tilt, 127 active stand, 1042 CSM and 382 prolonged tilt). Ages ranged from 11 to 91 years with a median (IQR) of 75 (62-81) years. There were 1914 females; 1088 males. Orthostatic hypotension (OH) was the most commonly observed abnormality (test positivity of 60.3%). Those with OH had a median (IQR) age of 78 (71-83) years. Symptomatic patients were significantly younger than asymptomatic (P = 0.03). NCS demonstrated a bimodal age distribution. Of 194 patients with carotid sinus hypersensitivity, the median age (IQR) was 77 (68-82) years. Those with vasovagal syncope (n = 80) had a median (IQR) age of 30 (19-44) years. There were 57 patients with isolated postural orthostatic tachycardia syndrome. Of the total patients, 75% were female. They had a median (IQR) age of 23 (17-29) years.
We have confirmed, in a single population, a changing pattern in the aetiology of syncope as a person ages. The burden of disease is greatest in the elderly.
在单一人群中，报告广泛年龄范围内的晕厥评估结果的情况很少见。我们的目的是绘制随着患者年龄的变化，直立性和神经心源性晕厥（NCS）的不同患病率。
这是一项回顾性研究。纳入了十年来转诊到三级转诊晕厥单位的所有连续患者。患者因反复跌倒或直立不耐受而被转诊。根据最佳实践指南进行倾斜试验和颈动脉窦按摩（CSM）。
共纳入 3002 例患者（1451 例短倾斜试验、127 例主动站立、1042 例 CSM 和 382 例延长倾斜试验）。年龄从 11 岁到 91 岁，中位数（IQR）为 75（62-81）岁。女性 1914 例，男性 1088 例。直立性低血压（OH）是最常见的异常（阳性率为 60.3%）。OH 患者的中位（IQR）年龄为 78（71-83）岁。有症状患者比无症状患者年轻（P = 0.03）。NCS 呈双峰年龄分布。在 194 例颈动脉窦过敏患者中，中位（IQR）年龄为 77（68-82）岁。血管迷走性晕厥患者（n = 80）的中位（IQR）年龄为 30（19-44）岁。孤立性体位性心动过速综合征患者 57 例。在总患者中，75%为女性。她们的中位（IQR）年龄为 23（17-29）岁。
我们在单一人群中证实了随着年龄的增长，晕厥病因的模式发生了变化。随着年龄的增长，疾病负担最大。
