Clinical Associations of Injuries Caused by Vasovagal Syncope: A Cohort Study From a Tertiary Syncope Unit
Background Recent research has revealed that vasovagal syncope (VVS) leads to a high incidence of injuries; however, clinical associations of injury are not well‐established. We present data from an ongoing VVS cohort and aimed to determine characteristics associated with VVS‐related injury. Methods...
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| Format: | Article |
| Language: | English |
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Wiley
2023-01-01
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| Series: | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| Subjects: | |
| Online Access: | https://www.ahajournals.org/doi/10.1161/JAHA.122.027272 |
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| author | Masih Tajdini Hamed Tavolinejad Arya Aminorroaya Zahra Aryan Arash Jalali Farshid Alaeddini Saeed Sadeghian Somayeh Yadangi Ali Vasheghani‐Farahani Parvin Kalhor Ali Bozorgi |
| author_facet | Masih Tajdini Hamed Tavolinejad Arya Aminorroaya Zahra Aryan Arash Jalali Farshid Alaeddini Saeed Sadeghian Somayeh Yadangi Ali Vasheghani‐Farahani Parvin Kalhor Ali Bozorgi |
| author_sort | Masih Tajdini |
| collection | DOAJ |
| description | Background Recent research has revealed that vasovagal syncope (VVS) leads to a high incidence of injuries; however, clinical associations of injury are not well‐established. We present data from an ongoing VVS cohort and aimed to determine characteristics associated with VVS‐related injury. Methods and Results Between 2017 and 2020, consecutive patients ≥18 years of age presenting to a tertiary syncope unit and diagnosed with VVS were included. Clinical characteristics relevant to syncope were obtained for the index episode. The outcome was incidence of injury during VVS, documented by clinical evaluation at the syncope clinic. Among 1115 patients (mean age, 45.9 years; 48% women), 260 injuries (23%) occurred. History of VVS‐related injuries (adjusted relative risk [aRR], 1.80 [95% CI, 1.42–2.29]), standing position (aRR, 1.34 [95% CI, 1.06–1.68]), and female sex (aRR, 1.30 [95% CI, 1.06–1.60]) were associated with injury, whereas recurrent VVS (aRR, 0.63 [95% CI, 0.49–0.81]) and syncope in the noon/afternoon (aRR, 0.70 [95% CI, 0.56–0.87]) and evening/night (aRR, 0.43 [95% CI, 0.33–0.57]) compared with morning hours were associated with lower risk. There was a trend for higher rates of injury with overweight/obesity (aRR, 1.23 [95% CI, 0.99–1.54]) and syncope occurring at home (aRR, 1.22 [95% CI, 0.98–1.51]). In a per‐syncope analysis considering up to 3 previous episodes (n=2518, 36% traumatic), syncope at home (aRR, 1.33 [95% CI, 1.17–1.51]) and absence of prodromes (aRR, 1.34 [95% CI, 1.09–1.61]) were associated with injury. Conclusions Patient characteristics, VVS presentations, the circumstances, and surroundings can determine the risk of injury. These associations of VVS‐related injury identify at‐risk individuals and high‐risk situations. Future prospective studies are needed to investigate potential strategies for prevention of post‐VVS injury in recurrent cases. |
| first_indexed | 2024-04-10T09:59:28Z |
| format | Article |
| id | doaj.art-ee72be07925a4e79b5a0d6cedfcb3279 |
| institution | Directory Open Access Journal |
| issn | 2047-9980 |
| language | English |
| last_indexed | 2024-04-10T09:59:28Z |
| publishDate | 2023-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| spelling | doaj.art-ee72be07925a4e79b5a0d6cedfcb32792023-02-16T10:55:33ZengWileyJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease2047-99802023-01-0112110.1161/JAHA.122.027272Clinical Associations of Injuries Caused by Vasovagal Syncope: A Cohort Study From a Tertiary Syncope UnitMasih Tajdini0Hamed Tavolinejad1Arya Aminorroaya2Zahra Aryan3Arash Jalali4Farshid Alaeddini5Saeed Sadeghian6Somayeh Yadangi7Ali Vasheghani‐Farahani8Parvin Kalhor9Ali Bozorgi10Tehran Heart Center, Cardiovascular Diseases Research Institute Tehran University of Medical Sciences Tehran IranTehran Heart Center, Cardiovascular Diseases Research Institute Tehran University of Medical Sciences Tehran IranTehran Heart Center, Cardiovascular Diseases Research Institute Tehran University of Medical Sciences Tehran IranDepartment of Medicine Rutgers New Jersey Medical School Newark NYTehran Heart Center, Cardiovascular Diseases Research Institute Tehran University of Medical Sciences Tehran IranTehran Heart Center, Cardiovascular Diseases Research Institute Tehran University of Medical Sciences Tehran IranTehran Heart Center, Cardiovascular Diseases Research Institute Tehran University of Medical Sciences Tehran IranTehran Heart Center, Cardiovascular Diseases Research Institute Tehran University of Medical Sciences Tehran IranTehran Heart Center, Cardiovascular Diseases Research Institute Tehran University of Medical Sciences Tehran IranTehran Heart Center, Cardiovascular Diseases Research Institute Tehran University of Medical Sciences Tehran IranTehran Heart Center, Cardiovascular Diseases Research Institute Tehran University of Medical Sciences Tehran IranBackground Recent research has revealed that vasovagal syncope (VVS) leads to a high incidence of injuries; however, clinical associations of injury are not well‐established. We present data from an ongoing VVS cohort and aimed to determine characteristics associated with VVS‐related injury. Methods and Results Between 2017 and 2020, consecutive patients ≥18 years of age presenting to a tertiary syncope unit and diagnosed with VVS were included. Clinical characteristics relevant to syncope were obtained for the index episode. The outcome was incidence of injury during VVS, documented by clinical evaluation at the syncope clinic. Among 1115 patients (mean age, 45.9 years; 48% women), 260 injuries (23%) occurred. History of VVS‐related injuries (adjusted relative risk [aRR], 1.80 [95% CI, 1.42–2.29]), standing position (aRR, 1.34 [95% CI, 1.06–1.68]), and female sex (aRR, 1.30 [95% CI, 1.06–1.60]) were associated with injury, whereas recurrent VVS (aRR, 0.63 [95% CI, 0.49–0.81]) and syncope in the noon/afternoon (aRR, 0.70 [95% CI, 0.56–0.87]) and evening/night (aRR, 0.43 [95% CI, 0.33–0.57]) compared with morning hours were associated with lower risk. There was a trend for higher rates of injury with overweight/obesity (aRR, 1.23 [95% CI, 0.99–1.54]) and syncope occurring at home (aRR, 1.22 [95% CI, 0.98–1.51]). In a per‐syncope analysis considering up to 3 previous episodes (n=2518, 36% traumatic), syncope at home (aRR, 1.33 [95% CI, 1.17–1.51]) and absence of prodromes (aRR, 1.34 [95% CI, 1.09–1.61]) were associated with injury. Conclusions Patient characteristics, VVS presentations, the circumstances, and surroundings can determine the risk of injury. These associations of VVS‐related injury identify at‐risk individuals and high‐risk situations. Future prospective studies are needed to investigate potential strategies for prevention of post‐VVS injury in recurrent cases.https://www.ahajournals.org/doi/10.1161/JAHA.122.027272injuriesphysical injurysyncopetraumavasovagal syncope‐related injuryvasovagal syncope |
| spellingShingle | Masih Tajdini Hamed Tavolinejad Arya Aminorroaya Zahra Aryan Arash Jalali Farshid Alaeddini Saeed Sadeghian Somayeh Yadangi Ali Vasheghani‐Farahani Parvin Kalhor Ali Bozorgi Clinical Associations of Injuries Caused by Vasovagal Syncope: A Cohort Study From a Tertiary Syncope Unit Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease injuries physical injury syncope trauma vasovagal syncope‐related injury vasovagal syncope |
| title | Clinical Associations of Injuries Caused by Vasovagal Syncope: A Cohort Study From a Tertiary Syncope Unit |
| title_full | Clinical Associations of Injuries Caused by Vasovagal Syncope: A Cohort Study From a Tertiary Syncope Unit |
| title_fullStr | Clinical Associations of Injuries Caused by Vasovagal Syncope: A Cohort Study From a Tertiary Syncope Unit |
| title_full_unstemmed | Clinical Associations of Injuries Caused by Vasovagal Syncope: A Cohort Study From a Tertiary Syncope Unit |
| title_short | Clinical Associations of Injuries Caused by Vasovagal Syncope: A Cohort Study From a Tertiary Syncope Unit |
| title_sort | clinical associations of injuries caused by vasovagal syncope a cohort study from a tertiary syncope unit |
| topic | injuries physical injury syncope trauma vasovagal syncope‐related injury vasovagal syncope |
| url | https://www.ahajournals.org/doi/10.1161/JAHA.122.027272 |
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