Background and aims: The PS structures comprise an epidemiological observatory of syncopal episodes (SE). Only a few studies of this sort are available in Italy: the data reported here represents an epidemiological and clinical contribution to the evaluation of this pathology.
Methods: The retrospective study was based on PS registers and on medical records, enrolling all patients aged > 13 years old who attended the PS between 1/1/1992 and 31/12/1992 for syncopal or near syncopal episodes.
Results: During the period in question, a total of 697 SE were observed in 684 patients (363 males and 321 females) with an incidence of 268 x 10(5)/year (1.3% of all admissions to PS); 530 SE (76%) were admitted to hospital (3.6% of all emergencies), 78.1% of which to the Emergency Medical ward. Intrahospital mortality was 13 SE. The following parameters were assessed: mean age 57.5 years (range 15-93), distribution by age bracket, place where SE occurred, posture and any trauma, present in 197 SE (28.2%), including 27 cases of bone fracture; 180 SE (25.9%) reported at least one similar earlier episode and 13 patients showed recurrence during the study period; the main potentially correlated chronic pathologies (the most frequent were arterial hypertension, CIC, diabetes mellitus), pharmacological treatment; the diagnostic assessment on discharge for the entire series (cardiogenic 12.6%, non-cardiogenic 69.6%, unknown genesis 16.9%) and in the case of hospitalised SE alone, the concordance was evaluated between diagnosis at admission and discharge (positive in 60.9%); the use of instrumental diagnostics and their diagnostic contribution.
Conclusions: The incidence of syncopal pathology was confirmed to be high in PS, more so in patients admitted to hospital. Compared to other series, there were more SE caused by vasovagal mechanisms, ortyhostatic hypotension and psychogenic causes which together accounted for 46.3%, those caused by cerebral vasculopathies and supraventricular hyperkinetic arrhythmia at onset.