@article{ref1,
title="The prevalence of Neurally Mediated Syncope in older patients presenting with unexplained falls",
journal="European journal of internal medicine",
year="2012",
author="Anpalahan, Mahesan and Gibson, Stephen",
volume="23",
number="2",
pages="e48-52",
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.<p /> <p>Language: en</p>",
language="en",
issn="0953-6205",
doi="10.1016/j.ejim.2011.10.010",
url="http://dx.doi.org/10.1016/j.ejim.2011.10.010"
}