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Introduction: Syncope could be associated with high risk of falls and injury in adults, but documentation is sparse.

Purpose: We examined the association between syncope and fall-related injuries in a nationwide prospective cohort.

Methods: By individual-level linkage of nationwide registries, all Danish residents ≥18 years with a first-time diagnosis of syncope (hospital admission or emergency department visit) were identified from 1997 through 2012. Syncope patients were matched 1:1 with individuals from the general population through risk-set matching by year of birth and sex. The absolute 1-year risk of fall-related injuries, defined as fractures and traumatic brain and/or head injury requiring hospitalization, was calculated using the Aalen-Johansen estimator. Ratios of the absolute 1-year risk of fall-related injuries (ARR) were assessed by multiple absolute risk regression.

Results: We identified 116,665 adult patients with first-time syncope: median age 65 years (interquartile range [IQR], 47 to 78), 60,978 (52.3%) women, and 37,871 (32.5%) had cardiovascular disease. At 1 year, follow-up was complete for 99.8% where a total of 7868 (6.7%) patients sustained a fall-related injury requiring hospitalization, of which 1517 (19.3%) suffered hip fracture. In the reference cohort, 3763 (3.2%) persons had a fall-related injury. The 1-year absolute risk ratio of a fall-related injury was ARR, 1.80 (95% CI, 1.73–1.88, P<0.001) in patients with syncope compared with the reference population. Increased 1-year risk of fall-related injuries was associated with: use of loop diuretic drugs (ARR, 1.25, 95% CI, 1.05–1.49, P<0.001), anxiolytic drugs (ARR, 1.76, 95% CI, 1.58–1.96, P<0.001), and low socioeconomic status (ARR, 1.49, 95% CI, 1.29–1.72, P<0.001) in patients <65 years; and depression (ARR, 1.38, 95% CI, 1.29–1.47, P<0.001), and prior fall-related injury in past 12 months (ARR, 1.90, 95% CI, 1.76–2.05, P<0.001) in patients ≥65 years.

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Abstracts > Saturday 26 August 2017
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