Long-term survival after transient loss of consciousness.

To determine the factors that influenced the long-term outcome of 198 patients who presented to the emergency ward with transient loss of consciousness, the authors followed them for a median of 83 months. Forty-one patients (21%) died, including nine patients who had out-of-hospital sudden cardiac arrest. Compared with age- and sex-adjusted mortality rates for the United States, long-term mortality was not increased among patients with benign causes of syncope. Multivariate analysis revealed that the long-term mortality rate was significantly increased in patients with a prior history of coronary or cerbrovascular disease (RR = 6.7), those who had cancer (RR = 7.3), and those who had drug or metabolic (RR = 5.9), central nervous system (RR = 5.7) or cardiac (RR = 9.2) causes of transient loss of consiousness. Among patients who experience transient losses of consciousness, the cause of the episode is significantly correlated with mortality for at least the next seven years.