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Near Syncope = Syncope in Elderly

January 8, 2019

Written by Clay Smith

Spoon Feed
Near syncope had the same risk of death or serious adverse clinical event as syncope in patients ≥60 years old.

Why does this matter?
Dr. Keith Wrenn always taught that near syncope is syncope. Once again, he’s right. We may be falsely reassured that an elderly patient didn’t completely lose consciousness but simply “went down.” Actually, this is not reassuring at all.

Near syncope = syncope
This was a prospective multicenter study of 3,581 elderly (≥60 years) patients presenting with either syncope or near syncope. They were followed for 30 days for death or serious adverse clinical event and found the near syncope group had this outcome in 18.7%; the syncope group in 18.2%, which was statistically the same. Near syncope had the same risk as syncope in older patients and should be considered the same clinical entity.

Another Spoonful
Anand Swaminathan unpacked this in a REBEL EM post (a year ago…looks like I’m late to the party).

Comparison of 30-Day Serious Adverse Clinical Events for Elderly Patients Presenting to the Emergency Department With Near-Syncope Versus Syncope. Ann Emerg Med. 2018 Dec 7. pii: S0196-0644(18)31420-3. doi: 10.1016/j.annemergmed.2018.10.032. [Epub ahead of print]

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