RECURRENT SYNCOPE IN ELDERLY PATIENTS AND TILT TEST TABLE OUTCOME: THE ROLE OF COMORBIDITIES

Abstract

Syncope is a common disorder that can lead to serious consequences in the elderly. Tilt-test is a safe, useful specific tool to investigate recurrent syncope also in the elderly. Comorbidities and medication use, widely present in elderly patients, affecting the hemodynamic response, can influence the tilt-test outcome. The aim of this study was to evaluate the influence of these confounding factors on tilt-test results in elderly patients with recurrent syncope. We included in this study a consecutive group of 87 patients > 75 years (82.1 ± 4.3 years) with unexplained syncope. They underwent passive upright tilt-test. Heart rate an blood pressure were recorded using non-invasive devices. The patients were classified according to the modified Vasovagal Syncope International Study (VASIS). Comorbidities were measured with the geriatric index of comorbidities (GIC), which is a composite score taking into account both the number of diseases and their severity as measured by Greenfield's IDS. The tilt-test was positive in 22 patients. There were no significant differences in clinical characteristics, and medication use between the tilt-test negative and positive patients, except for the GIC score (1.12 ± 0.5 vs. 2.42 ± 0.48; p = 0.001) and for a reduced number of medications in the former group (5.7 ± 3.1 vs. 8.2 ± 2.4; p = 0.001). This study suggests that comorbidities and the number of medications could influence tilt test outcome.