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History of syncope predicts loss of consciousness after head trauma: Retrospective study

Zysko, Dorota ; Sutton, Richard ; Timler, Dariusz ; Furtan, Stanislaw ; Melander, Olle LU orcid and Fedorowski, Artur LU orcid (2014) In Cardiology Journal 21(6). p.674-678
Abstract
Background: Head trauma may present as transient loss of consciousness (TLOC) currently classified as traumatic in origin, in contrast to non-traumatic forms, such as syncope. Whether past history of syncope predisposes to loss of consciousness after head injury has been poorly studied. Methods: A retrospective analysis of data obtained from 818 consecutive patients admitted to Emergency Departments was conducted. Face-to-face semi-structured interviews were performed, where patients' past history of syncope and head injury were explored. Head injury events were stratified as high-or low-energy trauma. Data regarding past syncopal events were explored in regard to number, age at the first occurrence, and syncope circumstances. Multivariate... (More)
Background: Head trauma may present as transient loss of consciousness (TLOC) currently classified as traumatic in origin, in contrast to non-traumatic forms, such as syncope. Whether past history of syncope predisposes to loss of consciousness after head injury has been poorly studied. Methods: A retrospective analysis of data obtained from 818 consecutive patients admitted to Emergency Departments was conducted. Face-to-face semi-structured interviews were performed, where patients' past history of syncope and head injury were explored. Head injury events were stratified as high-or low-energy trauma. Data regarding past syncopal events were explored in regard to number, age at the first occurrence, and syncope circumstances. Multivariate logistic regression model was applied to assess the relationship between loss of consciousness during head injury and past history of syncope. Results: Both past history of non-traumatic TLOC (odds ratio [OR] 3.78; 95% confidence interval [CI] 2.13-6.68, p < 0.001) and high-energy mechanism (OR 3.84; 95% CI 2.35-6.28, p < 0.001) predicted TLOC after head trauma. This relationship was even stronger when past episodes of TLOC were limited to those typical for reflex syncope (OR 4.34; 95% CI 2.34-7.89, p < 0.001). Further, the number of non-traumatic TLOC episodes in the patient's history was also predictive of TLOC after head injury (OR per 1 episode: 1.24; 95% CI 1.04-1.48, p = 0.015). Conclusions: Syncope in a patient's history predicts loss of consciousness after head injury. The clinical importance of this finding merits further investigation. (Less)
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author
; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
head trauma, emergency department, loss of consciousness, syncope, vasovagal syncope
in
Cardiology Journal
volume
21
issue
6
pages
674 - 678
publisher
Via Medica
external identifiers
  • wos:000349190800014
  • scopus:84920189885
  • pmid:25524736
ISSN
1898-018X
DOI
10.5603/CJ.2014.0099
language
English
LU publication?
yes
id
6097e84a-4670-4fa1-9092-349a5a6427b0 (old id 5200911)
date added to LUP
2016-04-01 10:32:43
date last changed
2024-01-06 19:27:33
@article{6097e84a-4670-4fa1-9092-349a5a6427b0,
  abstract     = {{Background: Head trauma may present as transient loss of consciousness (TLOC) currently classified as traumatic in origin, in contrast to non-traumatic forms, such as syncope. Whether past history of syncope predisposes to loss of consciousness after head injury has been poorly studied. Methods: A retrospective analysis of data obtained from 818 consecutive patients admitted to Emergency Departments was conducted. Face-to-face semi-structured interviews were performed, where patients' past history of syncope and head injury were explored. Head injury events were stratified as high-or low-energy trauma. Data regarding past syncopal events were explored in regard to number, age at the first occurrence, and syncope circumstances. Multivariate logistic regression model was applied to assess the relationship between loss of consciousness during head injury and past history of syncope. Results: Both past history of non-traumatic TLOC (odds ratio [OR] 3.78; 95% confidence interval [CI] 2.13-6.68, p &lt; 0.001) and high-energy mechanism (OR 3.84; 95% CI 2.35-6.28, p &lt; 0.001) predicted TLOC after head trauma. This relationship was even stronger when past episodes of TLOC were limited to those typical for reflex syncope (OR 4.34; 95% CI 2.34-7.89, p &lt; 0.001). Further, the number of non-traumatic TLOC episodes in the patient's history was also predictive of TLOC after head injury (OR per 1 episode: 1.24; 95% CI 1.04-1.48, p = 0.015). Conclusions: Syncope in a patient's history predicts loss of consciousness after head injury. The clinical importance of this finding merits further investigation.}},
  author       = {{Zysko, Dorota and Sutton, Richard and Timler, Dariusz and Furtan, Stanislaw and Melander, Olle and Fedorowski, Artur}},
  issn         = {{1898-018X}},
  keywords     = {{head trauma; emergency department; loss of consciousness; syncope; vasovagal syncope}},
  language     = {{eng}},
  number       = {{6}},
  pages        = {{674--678}},
  publisher    = {{Via Medica}},
  series       = {{Cardiology Journal}},
  title        = {{History of syncope predicts loss of consciousness after head trauma: Retrospective study}},
  url          = {{http://dx.doi.org/10.5603/CJ.2014.0099}},
  doi          = {{10.5603/CJ.2014.0099}},
  volume       = {{21}},
  year         = {{2014}},
}