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[晕厥患者的驾驶状态并非标准建议的一部分]

[Driving status of syncope patients is not part of standard advice].

作者信息

Snijders Blok M R, de Lange F J, Thijs R D, van Dijk J G, Wieling W, van Dijk N

机构信息

Academisch Medisch Centrum, Amsterdam.

出版信息

Ned Tijdschr Geneeskd. 2017;161:D1328.

Abstract

OBJECTIVE

Some medical problems, such as syncope, have direct consequences for fitness to drive. Our objective was to discover if patients had been informed about their driving status after a syncopal episode by their physician, and if this advice was in line with current legislation.

DESIGN

Cross-sectional study.

METHOD

By means of a structured questionnaire, 150 patients referred to the syncope clinic at the Academic Medical Centre, Amsterdam, were asked about the advice they had received concerning their driving status during previous consultations with their general practitioner or specialists. A syncope expert then assessed the driving status of all patients in the light of the existing and new ruling.

RESULTS

In 121 of the 150 patients (81%), a certain or highly-likely cause for their loss of consciousness was determined: 68 patients had reflex syncope, 25 patients orthostatic hypotension, 20 patients psychogenic pseudosyncope, three patients cardiac syncope, three patients had epilepsy and two patients another diagnosis. Seven patients had experienced an episode while driving. Only 26/150 patients (17%) reported that the consequences of their episodes for their driving status had been discussed with them at earlier consultations. If driving was discussed, in only 31% had the current Dutch legislation on driving been followed. Over a third (38%) of the patients felt they should no longer drive.

CONCLUSION

Fewer than one in five patients reported that driving status was discussed by a physician after a syncope episode. If advice had been given, it was often not in line with current legislation.

摘要

目的

一些医学问题,如晕厥,会对驾驶适宜性产生直接影响。我们的目的是了解患者在晕厥发作后是否已被医生告知其驾驶状态,以及该建议是否符合现行法律规定。

设计

横断面研究。

方法

通过结构化问卷,对转诊至阿姆斯特丹学术医疗中心晕厥门诊的150名患者进行调查,询问他们在之前与全科医生或专科医生会诊时所收到的关于其驾驶状态的建议。然后,一位晕厥专家根据现行及新的规定对所有患者的驾驶状态进行评估。

结果

150名患者中有121名(81%)确定了其意识丧失的某种或极有可能的原因:68名患者为反射性晕厥,25名患者为体位性低血压,20名患者为心因性假性晕厥,3名患者为心源性晕厥,3名患者患有癫痫,2名患者为其他诊断。7名患者在驾驶时发作过。只有26/150名患者(17%)报告称在之前的会诊中讨论过发作对其驾驶状态的影响。如果讨论了驾驶问题,只有31%遵循了荷兰现行的驾驶立法。超过三分之一(38%)的患者认为自己不应再开车。

结论

不到五分之一的患者报告称晕厥发作后医生讨论过其驾驶状态。如果给出了建议,往往不符合现行法律规定。

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