Abstract:

Objective

To explore the assessment value of Charlson comorbidity index （CCI）on short-term and long-term clinical prognosis of patients experiencing syncope.

Methods

Patients with syncope who visited the cardiology department of the Second Hospital of Tianjin Medical University from June 18， 2018 to July 19， 2021 were enrolled. we identified the syncope type of the patient， and baseline data were obtained and CCI were calculated through clinical assessment and survey study. According to the CCI classification， the disease burden of patients was classified as: very low （CCI 0）， low （CCI 1-2）， moderate （CCI 3-4）， and severe （CCI ≥5）. Logistic regression analysis was used to evaluate the association of CCI with short-term （30 days） and long-term （1， 2， and 3 years） risk of syncope recurrence， readmission， and death in syncope patients.

Results

A total of 313 patients were included， with reflex syncope in 57， cardiac syncope in 134， and other causes in 122. Multivariate Logistic regression showed that for every 1-point increase in CCI， the risk of patient readmission at 30 days and 1 year of follow-up increased by approximately 0.4 times（OR=1.417， 95%CI: 1.057-1.899） and 0.3 times （OR=1.300， 95%CI: 1.051-1.608）， respectively. Furthermore，the risk of mortality at 1， 2， and 3 years post-discharge was significantly elevated by approximately 0.8 times（1 year: OR=1.785， 95%CI: 1.270-2.509； 2 years: OR=1.771， 95%CI: 1.179-2.662； 3 years: OR=1.785，95%CI: 1.176-2.709）. However， increased CCI did not significantly predict the risk of syncope recurrence at short- and long-term follow-up （P＞0.05）.

Conclusion

CCI is positively associated with short- and longterm risk of readmission and risk of death in patients with syncope， it does not significantly correlate with the risk of syncope recurrence. Early identification of high-risk patients using CCI with focused surveillance and early intervention， and individualized treatment and rehabilitation plans based on co-morbidities may help reduce syncope readmission rates and mortality.

Key words: Syncope, Charlson comorbidity index, Adverse prognosis