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History of syncope predicts loss of consciousness after head trauma: Retrospective study
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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 < 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.
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 < 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.
Keywords
head trauma, emergency department, loss of consciousness, syncope, vasovagal syncope
About this articleTitle
History of syncope predicts loss of consciousness after head trauma: Retrospective study
Journal
Issue
Pages
674-678
Published online
2014-12-18
Page views
1714
Article views/downloads
3975
DOI
10.5603/CJ.2014.0099
Bibliographic record
Cardiol J 2014;21(6):674-678.
Keywords
head trauma
emergency department
loss of consciousness
syncope
vasovagal syncope
Authors
Dorota Zyśko
Richard Sutton
Dariusz Timler
Stanisław Furtan
Olle Melander
Artur Fedorowski
