Department of Cardiac Sciences, Libin Cardiovascular Institute of Alberta, Cumming School of Medicine, University of Calgary, 3280 Hospital Drive NW, Calgary, Alberta T2N 4Z6, Canada.
Clinica Fit Labor Centro de Performance Humana, Niteroi, Rio de Janeiro, Brazil.
Europace. 2021 Jul 18;23(7):1092-1099. doi: 10.1093/europace/euab041.
Vasovagal syncope (VVS) is the most common type of syncope and is usually considered a benign disorder. The potential for injury is worrisome but the likelihood is unknown. We aimed to determine the proportion of patients injured due to VVS.
A systematic search of studies published until August 2020 was performed in multiple medical and nursing databases. Included studies had data on the proportion of patients with injury due to VVS prior to study enrolment. Random effects methods were used. Twenty-three studies having 3593 patients met inclusion criteria. Patients were diagnosed clinically with VVS, and 82% had >2 syncopal episodes before enrolment. Tilt test was positive in 60% and 14 studies reported comorbidities (32.6% hypertensive). The weighted mean injury rate was 33.5% [95% confidence interval (CI): 27.3-40.5%]. The likelihood of injury correlated with population age (r = 0.4, P = 0.05), but not with sex, positive tilt test, or hypertension. The injury rates were 25.7% (95% CI: 19.1-32.8%) in studies with younger patients (mean age ≤50 years, n = 1803) and 43.4% (95% CI: 34.9-52.3%) in studies with older patients (P = 0.002). Nine studies reported major injuries; with a weighted mean rate of major injuries of 13.9% (95% CI: 9.5-19.8%).
Injuries due to syncope are frequent, occurring in 33% of patients with VVS. The risk of major injuries is substantial. Older patients are at higher risk. Clinicians should be aware of the risk of injuries when providing care and advice to patients with VVS.
血管迷走性晕厥（VVS）是最常见的晕厥类型，通常被认为是一种良性疾病。但 VVS 具有潜在的受伤风险，其可能性尚不清楚。本研究旨在确定因 VVS 而受伤的患者比例。
我们对截至 2020 年 8 月发表的研究进行了系统检索，检索范围包括多个医学和护理数据库。纳入的研究均提供了研究入组前因 VVS 受伤患者的比例数据。采用随机效应模型进行分析。共有 23 项研究，纳入 3593 例患者，符合纳入标准。所有患者均经临床诊断为 VVS，82%的患者在入组前有>2 次晕厥发作。60%的患者倾斜试验阳性，14 项研究报告了合并症（32.6%为高血压）。加权平均损伤率为 33.5%[95%置信区间（CI）：27.3-40.5%]。损伤的可能性与人群年龄相关（r=0.4，P=0.05），但与性别、倾斜试验阳性或高血压无关。在纳入年轻患者（平均年龄≤50 岁，n=1803）的研究中，损伤发生率为 25.7%（95%CI：19.1-32.8%），而在纳入年龄较大患者（n=1790）的研究中，损伤发生率为 43.4%（95%CI：34.9-52.3%），两组间差异有统计学意义（P=0.002）。9 项研究报告了重大损伤，重大损伤的加权平均发生率为 13.9%（95%CI：9.5-19.8%）。
因晕厥而受伤的情况较为常见，VVS 患者中有 33%受伤。重大损伤的风险较高，老年患者风险更高。临床医生在为 VVS 患者提供护理和建议时，应意识到受伤的风险。
