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Afdrif sjúklinga eftir aðsvif

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Authors
Anna Jóhannsdóttir
Gizur Gottskálksson
Jóhann Ragnarsson
Issue Date
1994-10-01

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Other Titles
Mortality and resyncope in group of 111 patients five years after syncopal attack
Citation
Læknablaðið 1994, 80(8):387-91
Abstract
Mortality and resyncope were investigated after five years in 111 patients with syncope, a prospective study conducted at the Reykjavik City Hospital 1985-1986. Twenty one (18.9%) patients have died in this interval, 90 living, 81 patients were traced and resyncope occurred among 20 (24.7%) due to the same cause in 14 of 20 patients. Four patients died in the group (11) that was originally diagnosed with CVD disease (36.4% p<0.001) compared to expected mortality corrected for age, similar results were found in the group (22) with orthostatic hypotension as the cause of syncope. In the total group 21 died versus four expected (p<0.001). This confirms previous results by other investigators that mortality is high among this group of patients. In repeated study 1988-1989 we found that near syncope was frequently cardiovascular in origin and was a cause in 28% of patients, and orthostatic hypotension 20%. A syncope or near syncope should be investigated thoroughly to arrive at a diagnosis, especially in elderly people.
Hjá 111 sjúklingum með aðsvif, er rannsakaðir voru framvirkt á árunum 1985-1986, voru dánartíðni og endurtekið aðsvif skráð. Haft var samband við sjúklinga símleiðis, bréflega og einnig stuðst við dánarvottorð og sjúkraskrár. Af 111 sjúklingum dóu 21 (18,9%) á tímabilinu. Hjá þeim 90 er eftir lifðu fengust fullnægjandi upplýsingar hjá 81. Enduryfirlið kom fyrir hjá 20 sjúklingum og sjúkdómsgreining reyndist sama og sú upphaflega hjá 14 þeirra. Af 11 sjúklingum með hjarta- og æðasjúkdóma dóu fjórir. Búast hefði mátt við að 5,5% dæju en þeir reyndust 36,4% (p<0,001). Það sama varð uppi á teningnum meðal þeirra er leið yfir vegna blóðþrýstingsfalls (orthostatisma) (5,5% vs. 34,8%, p<0,001). Heildardánartíðni í þýðinu var 21 en búast hefði mátt við fjórum dánum miðað við staðaldánartíðni Norðurlandabúa p<0,001). Þetta staðfestir að horfur sjúklinga með yfirlið geta verið slæmar. Í nýrri rannsókn á yfirliðum og yfirliðakennd 1988-1989 kemur í ljós að hjarta- og æðasjúkdómar eru orsök yfirliöakenndar í 28% tilfella. Við leggjum því áherslu á að greina sjúklinga með yfirlið og yfirliðakennd, þannig að viðeigandi meðferð sé beitt í þeim tilgangi aö bæta lífslíkur sjúklinganna.
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