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A. Basics
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32. Cardiovascular Nursing
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The age factor - differences in syncope recurrence and mortality after the 40’s.
Session:
Painel 4- Arritmologia 3
Speaker:
Teresa Mota
Congress:
CPC 2020
Topic:
C. Arrhythmias and Device Therapy
Theme:
07. Syncope and Bradycardia
Subtheme:
07.2 Syncope and Bradycardia - Epidemiology, Prognosis, Outcome
Session Type:
Posters
FP Number:
---
Authors:
Teresa Faria Da Mota; Raquel Menezes Fernandes; Hugo Alex Costa; João De Sousa Bispo; Pedro Oliveira De Azevedo; Nuno Marques; Jorge Mimoso; Ilidio Paulos De Jesus
Abstract
<p><strong>Introduction:</strong> Age is currently regarded as having vital influence in syncope patients’ symptoms, diagnosis and evolution, inclusively determining the paths of investigation and follow-up of these individuals to a certain level.</p> <p><strong>Objectives:</strong> To compare patients under and over 40 years old regarding, outcomes of mortality and recurrence of syncope.</p> <p><strong>Methods: </strong>The authors present a retrospective, observational and analytical study, which included all patients with a first appointment at a Syncope Unit, between January 1st 2015 and December 11th 2019. Data were collected through clinical file analysis. Patients were split in two groups depending on their age (<40 and >40 years old). Statistical analysis was performed using SPSS 24,0 software. For analytical inferences, a significance level of 0,05 was used.</p> <p><strong>Results: </strong>The study included 694 patients (48,1% female, with a mean age of 63,6±21,4 years, min: 5, max: 96). Patients <40 were mainly female (61,5%) and >40 mostly male (54,6%), p=0,001. Regarding medical history, patients <40 had less CV risk factors (apart from active<br /> smoking), were less medicated, and were more commonly diagnosed with epilepsy. Family history of syncope, Acute Myocardial Infarction and stroke was also more common in this group. Considering final diagnosis, syncope in <40’s was more frequently attributed to a Vasovagal reflex (52,4% vs 28%, p< 0,001), while in >40’s medication, hypotension and bradycardia were the main culprits (11,6% vs 1,2%, p=0,004; 10,6% vs. 0%, p=0,002; 7% vs. 0%, p= 0,013).<br /> Regarding outcomes, syncope recurrence was not significantly different in both groups (19,8% vs. 16,2%, p=0,388). In patients <40, multivariate analysis only identified the “absence of prodromes” as an independent predictor of recurrence in the follow-up. On the other side, in patients >40, only previous medication with Calcium Chanel Blockers and presence of 1st degree AV block performed as an independent predictor of recurrence in the follow-up.<br /> Mortality on the other hand was significantly different between groups, as it only affected patients >40; a multivariate analysis showed dementia and systolic disfunction alone to be independent predictors of mortality on follow-up.</p> <p><strong>Conclusions: </strong>In the present study, <40 and >40 patients showed to be very heterogenous groups; even though age didn’t seem to have an impact on recurrence of syncope, it did influence mortality, which only affected older patients.</p>
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