P4835High incidence of injury due to vasovagal and bradyarrhythmic syncope
Bibliographic record
Abstract
Introduction: Recurrent syncope raises concerns about future risk of injury. Purpose: We aimed to determine the incidence, severity, and predictors of injuries due to syncope in patients (pts) with syncope in 3 clinical trials. Methods: POST studies are multi-centered randomized syncope treatment trials. POST 2 and 4 studied fludrocortisone and midodrine for vasovagal syncope, and POST 3 studied management strategies for bifascicular block and syncope. Injuries were recorded up to 1 year after enrollment. Injury was defined as minor (bruising, scrapes), moderate (lacerations), and severe (fracture, burns, joint pain). Time-dependent survival were tested with predictors Wilcoxon, and injury severity predictors with ANOVA. Results: Of 459 pts, 183 had at least 1 faint. Fully 97/210 (46%), 30/115 (26%), and 56/128 (44%) pts fainted in POST2, POST3 and POST 4 respectively, with a total 645 faints. Median ages were 34 yr, 74 yr, and 27 yr respectively, and total median age was 35 yr. The median prior yr syncope frequency was 3, with 85/183 (46%) having >3 faints/yr. Fully 58/183 pts (32%) had at least 1 injury related to syncope, and 95/645 faints (15%) resulted in injury. Of 58 injured pts, minor, moderate and severe injuries were reported by 47 (81%), 7 (12%), and 4 (7%) pts respectively. Of 95 injuries, 75 (79%), 16 (17%), and 4 (4%) were minor, moderate, and severe, respectively. Sex did not predict injury-free survival (male vs female, 75% vs 69% p=0.39) and above and below median age did not predict injury-free survival (old vs young, 71% vs 70% p=0.82). Injury-free survival was lower in pts with more frequent syncope in prior year (62% vs 79%, p=0.006 Wilcoxon). None of age, sex and prior year syncope frequency predicted injury severity (age, minor vs rest p=0.53; sex, minor vs rest, p=0.56; frequency, minor vs rest p=0.47. The absence of prodromal warnings did not predict injuries: In POST3 3/13 injured pts and 8/18 non-injured pts had prodromes (p=0.18). In POST4 9/16 injured pts and 32/40 non-injured pts in POST4 (p=0.07) had prodromes.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.005 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.005 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".