Lee R T, Cook E F, Day S C, Goldman L
Department of Medicine, Brigham and Women's Hospital, Boston, MA 02115.
J Gen Intern Med. 1988 Jul-Aug;3(4):337-43. doi: 10.1007/BF02595791.
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.
为确定影响198例因短暂意识丧失而就诊于急诊科患者长期预后的因素，作者对他们进行了为期83个月（中位数）的随访。41例患者（21%）死亡，其中9例患者发生院外心搏骤停。与美国经年龄和性别调整的死亡率相比，晕厥良性病因患者的长期死亡率并未升高。多因素分析显示，既往有冠状动脉或脑血管疾病史的患者（RR = 6.7）、患有癌症的患者（RR = 7.3）以及因药物或代谢（RR = 5.9）、中枢神经系统（RR = 5.7）或心脏（RR = 9.2）原因导致短暂意识丧失的患者，其长期死亡率显著升高。在经历短暂意识丧失的患者中，发作原因与至少未来7年的死亡率显著相关。
