晕厥患者发生晕厥后30d内死亡的危险因素探讨

Risk factors of death in 30 days after syncope

目的探讨晕厥患者发生晕厥后30d内死亡的危险因素。方法回顾性分析2010年6月至2016年6月空军总医院以晕厥为主诉或病程中伴发晕厥共516例的临床资料，多因素分析性别构成、年龄、既往是否有高血压史、糖尿病史、高脂血症史、吸烟史、饮酒史及是否心源性晕厥、神经反射性晕厥、体位性低血压及直立不耐受性晕厥、不明原因性晕厥、其他特殊疾病引起的晕厥等因素是否是晕厥患者发生晕厥后30d内死亡的危险因素。加入派生变量（以上因素两两交互后产生的新因素）后多因素分析晕厥患者发生晕厥后30d内死亡的危险因素。结果人选病例中男性321例（62．2％），女性195例（37．8％）；年龄（62．23±19．69）岁。未加人派生变量多重logistic回归分析结果：年龄[优势比（OR）=1．037，95％可信区间（95％CI）：1．008～1．058，P=0．0088，P〈0．05]及心源性晕厥[优势比（OR）=19．704，95％可信区间（95％CI）：5．894～65．875，P〈0．01]是晕厥患者晕厥发生后30d内死亡的独立的危险因素。加入派生变量多重logistic回归分析结果：心源性晕厥[优势比（OR）=11．487，95％可信区间（95％CI）：4．938～26．721，P〈0．01]、年龄与年龄交互派生变量[优势比（OR）=1．000，95％可信区间（95％CI）：1．000～1．000，P=0．0008，P〈0．01]、年龄与心源性晕厥交互派生变量[优势比（OR）=1．033，95％可信区间（95％CI）：1．022～1．044，P〈0．01堤晕厥患者晕厥发生后30d内死亡的独立的危险因素。结论年龄、心源性晕厥是晕厥患者晕厥发生后30d内死亡的独立危险因素；年龄与年龄、年龄与心源性晕厥交互作用产生的派生因素及心源性晕厥是晕厥患者晕厥发生后30d内死亡的独立危险因素。

Objective To investigate the risk factors of death in patients with syncope. Methods Clinical data of 516 patients experienced syncope admitted from June 2010 to June 2016 were analyzed retrospectively. Factors including gender, age, history of hypertension, diabetes mellitus, hyperlipidemia, smoking history, drinking history, and etiology of syncope （cardiogenic syncope, neuroreflex syncope, orthostatic hypotension, orthostatic syncope, unexplained syncope, and syncope caused by other special diseases） were analyzed as likely risk factors of death within 30 days after syncope happened. After adding the derived variables （over 22 new factors）, analyses were done to investigate independent risk factors of death for patients with syncope. Results This study included 321 male （62.2%） and 195 females （37.8%）, with mean age of （62.23±19.69） years. Logistic regression analyses showed that age （OR=1.033, 95% confidence interval （95%CI）：1.008-1.058, P =0.008 8）, cardiac syncope （OR=19.704, 95%CI：5.894-5.875, P〈0.01） were independent risk factors of death within 30 days after syncope occurred. Multiple-variate analysis with derived variables showed that cardiac syncope （OR= 11.487, 95%CI：4.938-26.721, P〈0.01）, age and age derived variables （OR=1.000, 95%CI： 1.000- 1.000, P=0.000 8）, age and cardiogenic syncope derivative variables （OR=1.033, 95%CI：1.022-1.044, P〈0.01） were independent risk factors for death within 30 days after syncope. Conclusion Age and cardiogenic syncope were independent risk factors for death within 30 days after syncope occurred. And a derivative factor of age, and interactivity between age and cardiac syncope were independent risk factors of death in patients with syncope.