Evidence map›Paper›PMID 30361153›Full record

Observational studyThe American journal of emergency medicine2019

Recurrent syncope is not an independent risk predictor for future syncopal events or adverse outcomes.

Anna Marie Chang, Judd E Hollander, Erica Su, Robert E Weiss, Annick N Yagapen, Susan E Malveau, David H Adler, Aveh Bastani, Christopher W Baugh, Jeffrey M Caterino and 9 more

Abstract readMulticenter StudyObservational Study
In one paragraph

Observational study in The American journal of emergency medicine, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. [Syncope diagnosis in the emergency room-importance of the ESC guidelines].Medizinische Klinik, Intensivmedizin und Notfallmedizin · 2026
    Article
  2. Article
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

19 authors.

Anna Marie ChangDepartment of Emergency Medicine, Thomas Jefferson University Hospital, Philadelphia, PA, United States of America. Electronic address: anna.m.chang@jefferson.edu.
Judd E HollanderDepartment of Emergency Medicine, Thomas Jefferson University Hospital, Philadelphia, PA, United States of America.
Erica SuDepartment of Biostatistics, University of California Los Angeles Fielding School of Public Health, Los Angeles, CA, United States of America.
Robert E WeissDepartment of Biostatistics, University of California Los Angeles Fielding School of Public Health, Los Angeles, CA, United States of America.
Annick N YagapenCenter for Policy and Research in Emergency Medicine, Department of Emergency Medicine, Oregon Heath & Science University, Portland, OR, United States of America.
Susan E MalveauCenter for Policy and Research in Emergency Medicine, Department of Emergency Medicine, Oregon Heath & Science University, Portland, OR, United States of America.
David H AdlerDepartment of Emergency Medicine, University of Rochester, NY, United States of America.
Aveh BastaniDepartment of Emergency Medicine, William Beaumont Hospital-Troy, Troy, MI, United States of America.
Christopher W BaughDepartment of Emergency Medicine, Brigham & Women's Hospital, Boston, MA, United States of America.
Jeffrey M CaterinoDepartment of Emergency Medicine, Ohio State University Wexner Medical Center, Columbus, OH, United States of America.
Carol L ClarkDepartment of Emergency Medicine, William Beaumont Hospital-Royal Oak, Royal Oak, MI, United States of America.
Deborah B DiercksDepartment of Emergency Medicine, University of Texas-Southwestern, Dallas, TX, United States of America.
Bret A NicksDepartment of Emergency Medicine, Wake Forest School of Medicine, Winston Salem, NC, United States.
Daniel K NishijimaDepartment of Emergency Medicine, UC Davis School of Medicine, Sacramento, CA, United States of America.
Manish N ShahDepartment of Emergency Medicine, University of Wisconsin-Madison, Madison, WI, United States of America.
Kirk A StifflerDepartment of Emergency Medicine, Northeast Ohio Medical University, Rootstown, OH, United States of America.
Alan B StorrowDepartment of Emergency Medicine, Vanderbilt University, Nashville, TN, United States of America.
Scott T WilberDepartment of Emergency Medicine, Northeast Ohio Medical University, Rootstown, OH, United States of America.
Benjamin C SunCenter for Policy and Research in Emergency Medicine, Department of Emergency Medicine, Oregon Heath & Science University, Portland, OR, United States of America.

Funding

Improving Syncope Risk Stratification in Older AdultsR01HL111033 · NHLBI · OREGON HEALTH & SCIENCE UNIVERSITY · PI SUN, BENJAMIN C · 2013 to 2017
$3.8M
NHLBI NIH HHS R01 HL111033
6 · The paper itself

Abstract

Almost 20% of patients with syncope will experience another event. It is unknown whether recurrent syncope is a marker for a higher or lower risk etiology of syncope. The goal of this study is to determine whether older adults with recurrent syncope have a higher likelihood of 30-day serious clinical events than patients experiencing their first episode.

methodsThis study is a pre-specified secondary analysis of a multicenter prospective, observational study conducted at 11 emergency departments in the US. Adults 60 years or older who presented with syncope or near syncope were enrolled. The primary outcome was occurrence of 30-day serious outcome. The secondary outcome was 30-day serious cardiac arrhythmia. In multivariate analysis, we assessed whether prior syncope was an independent predictor of 30-day serious events.

resultsThe study cohort included 3580 patients: 1281 (35.8%) had prior syncope and 2299 (64.2%) were presenting with first episode of syncope. 498 (13.9%) patients had 1 prior episode while 771 (21.5%) had >1 prior episode. Those with recurrent syncope were more likely to have congestive heart failure, coronary artery disease, previous diagnosis of arrhythmia, and an abnormal ECG. Overall, 657 (18.4%) of the cohort had a serious outcome by 30 days after index ED visit. In multivariate analysis, we found no significant difference in risk of events (adjusted odds ratio 1.09; 95% confidence interval 0.90-1.31; p = 0.387).

conclusionIn older adults with syncope, a prior history of syncope within the year does not increase the risk for serious 30-day events.

Indexed as

AgedAged, 80 and overCardiovascular DiseasesCase-Control StudiesEmergency Service, HospitalFemaleHumansMaleMiddle AgedProspective StudiesRecurrenceRisk AssessmentRisk FactorsSyncope

Identifiers

PMID30361153
PMCPMC6688170

What OpenQuestion holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.