Citation

Anpalahan M, Gibson S. Eur. J. Intern. Med. 2012; 23(2): e48-52.

Affiliation

Departments of General Medicine, Geriatrics, Nephrology and Metabolic Bone Diseases, Western Hospital, Melbourne, Victoria 3011, Australia.

Copyright

(Copyright © 2012, Elsevier Publishing)

DOI

10.1016/j.ejim.2011.10.010

PMID

22284256

Abstract

AIMS: To determine the prevalence and clinical significance of carotid sinus syndrome (CSS) and vasovagal syncope (VVS), the two common types of Neurally Mediated Syncope (NMS), in a cohort of older patients with unexplained falls. METHODS: Patients presenting with unexplained and accidental falls were identified from 200 consecutive admissions of falls in patients aged 65years and older admitted to the Rapid Assessment Medical Unit (RAMU) in a teaching hospital. A sample of unexplained and accidental fallers underwent carotid sinus massage (CSM) and tilt table testing (TTT) as per a standardised protocol. Baseline characteristics, clinical variables and the prevalence of NMS were compared between the two groups. RESULTS: Falls were unexplained in 26% of patients. The prevalence of NMS was 24% (5/21) among patients with unexplained falls who underwent assessment for NMS, whereas it was nil (0/17) in patients with accidental falls (P=0.050). The prevalence of previous falls was significantly higher in patients with unexplained falls (P=0.0025), but all other baseline characteristics were similar between the two groups. CONCLUSION: Falls are unexplained in a significant number of older patients presenting to acute hospitals. The assessment of unexplained fallers for NMS is clinically important as this may be aetiologically related in nearly a quarter of these patients.

Language: en