Abstract 13036: High Short-term Risk of Major Fall-related Injuries Following Hospitalization for Syncope - A Nationwide Study
Objective: Accidents and major injuries may be a common and serious consequence related to syncope, but the association is poorly elucidated. Our objective was to investigate the risk of subsequent fall-related injuries in a nationwide cohort of patients with a first-time diagnosis of syncope.
Methods: Patients aged 18 years and older hospitalized for syncope in Denmark in 1997 to 2011 were identified in nationwide administrative registers along with co-morbidity and concurrent pharmacotherapy. Fall-related injuries requiring hospitalization were obtained and classified as either minor or major. Injuries immediately in relation to index syncope were excluded. Time to first event and risk models were created using Cox regression analyses.
Results: We included 130,452 patients; median age 64 years (IQR 45-78) and 52% females. A total of 28,157 (22%) patients experienced at least one fall-related injury and hip fracture was the most frequent diagnosis among major injuries (n=5,296, 53%). Age stratified incidence rates are depicted in the Figure, showing particularly high risk during the first month. In adjusted Cox regression analysis atrial fibrillation (HR: 1.22, Cl: 1.03-1.45), use of loop-diuretics (HR: 1.18, Cl: 1.03-1.35), antidepressants (HR: 1.38, Cl: 1.23-1.53) and anxiolytics (HR: 1.27, Cl: 1.14-1.40) were significantly associated with increased short-term risk of overall fall-related injuries. Risk factors significantly associated with long-term injuries were heart failure (HR: 1.14, Cl: 1.04-1.26), previous strokes (HR: 1.30, Cl: 1.21-1.39) and dementia (HR: 1.56, Cl: 1.12- 2.17).
Conclusions: The risk of fall-related injuries is very high within the first month after syncope. Atrial fibrillation, use of loop-diuretics and psychotropics are risk factors among syncope patients that should cause increased awareness to prevent subsequent injuries.
- © 2013 by American Heart Association, Inc.