The usefulness of carotid sinus massage in different patient groups.

Abstract:

AIM:to determine the positive yield of carotid sinus massage in different patient groups: unexplained syncope, falls, dizziness and controls. DESIGN:observational study. SETTING:teaching hospital. METHODS:we studied consecutive patients over the age of 60 years referred to the 'falls clinic' with a history of unexplained syncope, unexplained falls and unexplained dizziness. We also studied asymptomatic control subjects recruited from a general practice register aged 60 years and over. All patients and control subjects underwent a full clinical assessment (comprehensive history and detailed clinical examination including supine and erect blood pressure measurements) and 12-lead electrocardiography. We performed carotid sinus massage in the supine position for 5 seconds separately on both sides followed by repeating the procedure in the upright positions using a motorised tilt table. Heart rate and blood pressure were recorded using a cardiac monitor and digital plethysmography respectively. The test was considered positive if carotid sinus massage produced asystole with more than a 3 second pause (cardioinhibitory type of carotid sinus syndrome), or a fall in systolic blood pressure of more than 50 mmHg in the absence of significant cardioinhibition (vasodepressor type of carotid sinus syndrome) or where there was evidence of both vasodepressor and cardio-inhibition as above (mixed type). RESULTS:we studied 44 asymptomatic control subjects and 221 symptomatic patients (130 with unexplained syncope, 41 with unexplained falls and 50 with unexplained dizziness). In the overall symptomatic patient group, the positive yield (any type of carotid sinus syndrome) was 17.6% (95% CI = 12.7-22.5). The positive yield in men (26.3% (95% CI = 16.4-36.2)) was twice that in women (13.1% (95% CI = 7.6-18.6)) (P = 0.014). Overall any type of carotid sinus syndrome was present in 22.3% (n = 29) of the syncope group, 17.1% (n = 7) in the unexplained fallers group and 6% (n = 3) in the dizziness group. We also found that no women with unexplained dizziness had a positive carotid sinus massage test. None of the controls demonstrated a positive response. None of the subjects suffered any complications during or after the test. CONCLUSION:the positive yield of carotid sinus massage in symptomatic patients was 17.6% with the yield in men being twice that in women. None of the asymptomatic control subjects demonstrated a positive response. The yields in unexplained syncope and unexplained falls patients were around 4-fold and 3-fold higher respectively than in unexplained dizziness patients. The positive yield in women with unexplained dizziness (without a definite history of syncope and falls) is zero. Hence, carotid sinus massage in older adults should particularly be targeted at patients with unexplained syncope and unexplained falls.

journal_name

Age Ageing

journal_title

Age and ageing

authors

Kumar NP,Thomas A,Mudd P,Morris RO,Masud T

doi

10.1093/ageing/afg114

subject

Has Abstract

pub_date

2003-11-01 00:00:00

pages

666-9

issue

6

eissn

0002-0729

issn

1468-2834

journal_volume

32

pub_type

杂志文章
  • Potential effect of skull thickening on the associations between cognition and brain atrophy in ageing.

    abstract:BACKGROUND:intracranial volume (ICV) is commonly used as a marker of premorbid brain size in neuroimaging studies as it is thought to remain fixed throughout adulthood. However, inner skull table thickening would encroach on ICV and could mask actual brain atrophy. OBJECTIVE:we investigated the effect that thickening ...

    journal_title:Age and ageing

    pub_type: 杂志文章

    doi:10.1093/ageing/afu070

    authors: Aribisala BS,Royle NA,Valdés Hernández MC,Murray C,Penke L,Gow A,Maniega SM,Starr JM,Bastin M,Deary I,Wardlaw J

    更新日期:2014-09-01 00:00:00

  • Slicing the health service cake: the Islington study.

    abstract:BACKGROUND:Little is known about the factors that are associated with receipt of care in older people. This study aims to describe the pattern and predictors of service usage, by a representative sample of people aged 65 and over. METHOD:We assessed psychiatric and physical morbidity, formal and informal care and pres...

    journal_title:Age and ageing

    pub_type: 杂志文章

    doi:10.1093/ageing/31.6.445

    authors: Nelson T,Livingston G,Knapp M,Manela M,Kitchen G,Katona C

    更新日期:2002-11-01 00:00:00

  • Patterns of emergency department attendance among older people in the last three months of life and factors associated with frequent attendance: a mortality follow-back survey.

    abstract:BACKGROUND:frequent emergency department (ED) attendance at the end of life disrupts care continuity and contradicts most patients' preference for home-based care. OBJECTIVE:to examine factors associated with frequent (≥3) end of life ED attendances among older people to identify opportunities to improve care. METHOD...

    journal_title:Age and ageing

    pub_type: 杂志文章

    doi:10.1093/ageing/afz043

    authors: Bone AE,Evans CJ,Henson LA,Gao W,Higginson IJ,BUILDCARE study.

    更新日期:2019-09-01 00:00:00

  • Socio-demographic differences in the onset and progression of disability in early old age: a longitudinal study.

    abstract:OBJECTIVES:to analyse socio-demographic differences in the onset and progression of disability. DESIGN:analysis of a cohort of people aged 55-69 in 1988-9 and in 1994. SUBJECTS:a representative sample of 3543 adults. METHODS:we measured severity of disability at baseline and follow-up. We analysed variations in inci...

    journal_title:Age and ageing

    pub_type: 杂志文章

    doi:10.1093/ageing/29.2.149

    authors: Grundy E,Glaser K

    更新日期:2000-03-01 00:00:00

  • Finding colorectal tumours with an immunological faecal occult blood test in symptomatic primary health care patients.

    abstract::The aim of this prospective study was to investigate whether an immunological double faecal occult blood test (Fecatwin-S/FECA-EIA) can be used in screening patients with symptoms suggestive of colonic or rectal origin in primary health care. Altogether 523 patients were referred to the study by general practitioners....

    journal_title:Age and ageing

    pub_type: 杂志文章

    doi:10.1093/ageing/23.5.365

    authors: Kemppainen M,Häkkinen I,Räihä I,Pomoell R,Sourander L

    更新日期:1994-09-01 00:00:00

  • The decision to work after state pension age and how it affects quality of life: evidence from a 6-year English panel study.

    abstract:Background:despite an increasing proportion of older people working beyond State Pension Age (SPA), little is known about neither the motivations for this decision nor whether, and to what extent, working beyond SPA affects quality of life (QoL). Methods:QoL was measured using the CASP-19 scale. Respondents in paid wo...

    journal_title:Age and ageing

    pub_type: 杂志文章

    doi:10.1093/ageing/afx181

    authors: Di Gessa G,Corna L,Price D,Glaser K

    更新日期:2018-05-01 00:00:00

  • Streamlining assessment and intervention in a falls clinic using the Timed Up and Go Test and Physiological Profile Assessments.

    abstract:BACKGROUND:The Timed Up and Go Test (TUGT) has been recommended as a simple screening tool to identify those at risk of falling. However, subsequent detailed assessment is required to identify underlying falls risk factors to provide direction for optimal targeted intervention strategies. METHODS:110 consecutive falls...

    journal_title:Age and ageing

    pub_type: 杂志文章

    doi:10.1093/ageing/afi178

    authors: Whitney JC,Lord SR,Close JC

    更新日期:2005-11-01 00:00:00

  • New horizons in the pathogenesis, assessment and management of delirium.

    abstract:UNLABELLED:Delirium is one of the foremost unmet medical needs in healthcare. It affects one in eight hospitalised patients and is associated with multiple adverse outcomes including increased length of stay, new institutionalisation, and considerable patient distress. Recent studies also show that delirium strongly pr...

    journal_title:Age and ageing

    pub_type: 杂志文章,评审

    doi:10.1093/ageing/aft148

    authors: Maclullich AM,Anand A,Davis DH,Jackson T,Barugh AJ,Hall RJ,Ferguson KJ,Meagher DJ,Cunningham C

    更新日期:2013-11-01 00:00:00

  • Best practice guidelines for the management of frailty: a British Geriatrics Society, Age UK and Royal College of General Practitioners report.

    abstract:UNLABELLED:Older people are majority users of health and social care services in the UK and internationally. Many older people who access these services have frailty, which is a state of vulnerability to adverse outcomes. The existing health care response to frailty is mainly secondary care-based and reactive to the ac...

    journal_title:Age and ageing

    pub_type: 杂志文章,实务指引,评审

    doi:10.1093/ageing/afu138

    authors: Turner G,Clegg A,British Geriatrics Society.,Age UK.,Royal College of General Practioners.

    更新日期:2014-11-01 00:00:00

  • The discharge of elderly patients from an accident and emergency department: functional changes and risk of readmission.

    abstract::Four hundred and fifty patients aged 75 years or older were followed up after discharge from an accident and emergency department. Forty-three per cent of all patients experienced some loss of functional independence. A small number, 5.6%, were readmitted to hospital within 14 days. This group were significantly less ...

    journal_title:Age and ageing

    pub_type: 杂志文章

    doi:10.1093/ageing/19.6.415

    authors: Rowland K,Maitra AK,Richardson DA,Hudson K,Woodhouse KW

    更新日期:1990-11-01 00:00:00

  • Preparation to care for confused older patients in general hospitals: a study of UK health professionals.

    abstract:BACKGROUND AND OBJECTIVE:in the UK, two-thirds of patients in general hospitals are older than 70, of whom half have dementia or delirium or both. Our objective was to explore doctors, nurses and allied health professionals' perceptions of their preparation to care for confused older patients on general hospital wards....

    journal_title:Age and ageing

    pub_type: 杂志文章

    doi:10.1093/ageing/aft171

    authors: Griffiths A,Knight A,Harwood R,Gladman JR

    更新日期:2014-07-01 00:00:00

  • A population-based study of sensorimotor factors affecting gait in older people.

    abstract:BACKGROUND:the study of factors associated with age-related gait decline may assist in developing methods to preserve mobility in older people. OBJECTIVE:to examine the associations between sensorimotor factors relevant to ageing and gait in the general older population. DESIGN:cross-sectional population-based study....

    journal_title:Age and ageing

    pub_type: 杂志文章

    doi:10.1093/ageing/afp017

    authors: Callisaya ML,Blizzard L,Schmidt MD,McGinley JL,Lord SR,Srikanth VK

    更新日期:2009-05-01 00:00:00

  • Informant ratings of cognitive decline of elderly people: relationship to longitudinal change on cognitive tests

    abstract::Formal assessment of cognitive decline with cognitive tests can be difficult, requiring either two measurement points or a comparison of 'hold' with 'don't hold' tests. Informant-based assessment provides an alternative approach because informants can adopt a longitudinal perspective and directly rate cognitive change...

    journal_title:Age and ageing

    pub_type: 杂志文章

    doi:

    authors: Jorm AF,Christensen H,Henderson AS,Jacomb PA,Korten AE,Mackinnon A

    更新日期:1996-03-01 00:00:00

  • Hospital use, institutionalisation and mortality associated with delirium.

    abstract:BACKGROUND:Delirium is a disorder affecting consciousness, which gives rise to core clinical features and associated symptoms. Older patients are particularly prone, owing to higher rates of pre-existing cognitive impairment, frailty, co-morbidity and polypharmacy. OBJECTIVES:The aim of this study was to investigate t...

    journal_title:Age and ageing

    pub_type: 杂志文章

    doi:10.1093/ageing/afq052

    authors: Eeles EM,Hubbard RE,White SV,O'Mahony MS,Savva GM,Bayer AJ

    更新日期:2010-07-01 00:00:00

  • The effects of discontinuing long-term diuretic therapy in the elderly.

    abstract::The effects of discontinuing long-term diuretic therapy were investigated by means of a double-blind randomized controlled trial. A total of 141 elderly patients in the long-stay wards of six hospitals were found to be taking maintenance diuretics, and for 33 of these the drugs were judged to be mandatory. Of the rema...

    journal_title:Age and ageing

    pub_type: 杂志文章

    doi:10.1093/ageing/6.1.38

    authors: Burr ML,King S,Davies HE,Pathy MS

    更新日期:1977-02-01 00:00:00

  • Why do healthy elderly people fail to comply with influenza vaccination?

    abstract:OBJECTIVE:to assess motivating factors of healthy elderly people to comply with influenza vaccination. DESIGN:survey of healthy elderly people invited by mail by their general practitioner to come for influenza vaccination. Compliance and the personal characteristics of gender, age and medical insurance were recorded ...

    journal_title:Age and ageing

    pub_type: 杂志文章

    doi:10.1093/ageing/26.4.275

    authors: van Essen GA,Kuyvenhoven MM,de Melker RA

    更新日期:1997-07-01 00:00:00

  • Folate status and its relation to vitamin C in healthy elderly men and women.

    abstract::Plasma and red-cell folate levels and dietary folate intake were monitored for about six months, including two months during which supplementary vitamin C was given, in 21 healthy elderly men and women living at home in the north of England. Although biochemical values were consistently low in some subjects, no clinic...

    journal_title:Age and ageing

    pub_type: 杂志文章

    doi:10.1093/ageing/9.4.241

    authors: Bates CJ,Fleming M,Paul AA,Black AE,Mandal AR

    更新日期:1980-11-01 00:00:00

  • Interleukin-1 production by human monocytes in ageing and disease.

    abstract::Interleukin-1 mediates the febrile response which is often said to be reduced in the elderly. Interleukin-1 production by monocytes cultured in vitro and stimulated with bacterial lipopolysaccharide was measured. Three groups of subjects were studied; 40 normal young, 33 well elderly and 40 elderly with a history of r...

    journal_title:Age and ageing

    pub_type: 杂志文章

    doi:10.1093/ageing/18.1.43

    authors: Rudd AG,Banerjee DK

    更新日期:1989-01-01 00:00:00

  • Duodenal ulcer disease in the elderly: a retrospective study.

    abstract::A retrospective study was performed of 163 patients aged 65 years and over with a diagnosis of duodenal ulceration admitted to one Health District over a period of six years. Eighty per cent of the patients were admitted with acute complications, 50% bled and 30% were perforated. A large proportion of these patients w...

    journal_title:Age and ageing

    pub_type: 杂志文章

    doi:10.1093/ageing/14.4.225

    authors: Watson RJ,Hooper TL,Ingram G

    更新日期:1985-07-01 00:00:00

  • Is there a role for physical activity in preventing cognitive decline in people with mild cognitive impairment?

    abstract::Mild cognitive impairment (MCI) is a common clinical syndrome that identifies people at high risk of developing dementia. Although treatments for MCI are currently unavailable, preliminary evidence has identified potential neuro-protective effects of physical activity, which may lead to improved outcomes. However, the...

    journal_title:Age and ageing

    pub_type: 杂志文章

    doi:10.1093/ageing/afr138

    authors: Barber SE,Clegg AP,Young JB

    更新日期:2012-01-01 00:00:00

  • Predictors of mortality in men and women aged 90 and older: a nine-year follow-up study in the Vitality 90+ study.

    abstract:BACKGROUND:information about the predictors of mortality among the oldest-old is limited. Also possible gender differences are poorly known. OBJECTIVE:to examine the predictors of mortality among individuals aged 90 and older, focusing on differences between men and women. We also analysed gender differences in surviv...

    journal_title:Age and ageing

    pub_type: 杂志文章

    doi:10.1093/ageing/aft030

    authors: Tiainen K,Luukkaala T,Hervonen A,Jylhä M

    更新日期:2013-07-01 00:00:00

  • Mental and physical health of elderly people: five-year follow-up of a total population.

    abstract::The change in mental and physical functioning over 5 years for 594 survivors of a community survey of the elderly is described. An increase in cognitive impairment, physical disability and incontinence over the period was found with increasing age. Women in the two oldest age groups had a significantly greater increas...

    journal_title:Age and ageing

    pub_type: 杂志文章,评审

    doi:10.1093/ageing/18.2.77

    authors: Jagger C,Clarke M,Cook AJ

    更新日期:1989-03-01 00:00:00

  • Proximity to death is associated with frequency of GP contacts in the oldest old: the Leiden 85-plus study.

    abstract:BACKGROUND:the relationship between proximity to death and the amount of care provided by general practitioners (GPs) is largely unknown. OBJECTIVE:to examine the influence of the proximity to death on the frequency and length of GP contacts in the oldest old. STUDY DESIGN:this population-based follow-up study includ...

    journal_title:Age and ageing

    pub_type: 杂志文章

    doi:10.1093/ageing/afs062

    authors: Blom JW,Lemmens SP,Assendelft WJ,Eekhof JA,Gussekloo J

    更新日期:2012-11-01 00:00:00

  • Recent syncope and unexplained falls are associated with poor cognitive performance.

    abstract:OBJECTIVE:To compare cognitive performance in participants with and without syncope and unexplained falls in a large population representative sample aged 50 years or older. METHODS:Participants of the Irish longitudinal study on ageing (TILDA) were studied. Participants with a history of syncope and/or unexplained fa...

    journal_title:Age and ageing

    pub_type: 杂志文章

    doi:10.1093/ageing/afu191

    authors: Frewen J,King-Kallimanis B,Boyle G,Kenny RA

    更新日期:2015-03-01 00:00:00

  • Metabolic syndrome and insulin resistance are associated with frailty in older adults: a prospective cohort study.

    abstract:Background:diabetes increases the risk of frailty that is a leading cause of disability and premature mortality in older people. Metabolic syndrome (MS) and insulin resistance (IR) are strong risk factors for diabetes and could, thus, lead to frailty. However, the association between MS or IR and frailty has barely bee...

    journal_title:Age and ageing

    pub_type: 杂志文章

    doi:10.1093/ageing/afx023

    authors: Pérez-Tasigchana RF,León-Muñoz LM,Lopez-Garcia E,Gutierrez-Fisac JL,Laclaustra M,Rodríguez-Artalejo F,Guallar-Castillón P

    更新日期:2017-09-01 00:00:00

  • Trends in hip fracture incidence and mortality in Chinese population from Hong Kong 2001-09.

    abstract:BACKGROUND:there is a suggestion that while the age-adjusted incidence of hip fracture in the West may be declining, the incidence may be rising in Asia. OBJECTIVE:this study examines the incidence and post-fracture mortality from 2001 to 2009 among the population aged 65 years and over. METHODS:hip fracture incidenc...

    journal_title:Age and ageing

    pub_type: 杂志文章

    doi:10.1093/ageing/afs177

    authors: Chau PH,Wong M,Lee A,Ling M,Woo J

    更新日期:2013-03-01 00:00:00

  • Interventions to improve adherence to exercise therapy for falls prevention in community-dwelling older adults: systematic review and meta-analysis.

    abstract:BACKGROUND:exercise therapy is highly recommended for falls prevention in older adults; however, poor exercise adherence may limit treatment effectiveness. OBJECTIVE:to assess the effectiveness of interventions to improve exercise adherence for community-dwelling adults (aged over 65 years), at risk of falling. METHO...

    journal_title:Age and ageing

    pub_type: 杂志文章,meta分析

    doi:10.1093/ageing/afy164

    authors: Hughes KJ,Salmon N,Galvin R,Casey B,Clifford AM

    更新日期:2019-03-01 00:00:00

  • Predicting incident delirium diagnoses using data from primary-care electronic health records.

    abstract:IMPORTANCE:risk factors for delirium in hospital inpatients are well established, but less is known about whether delirium occurring in the community or during an emergency admission to hospital care might be predicted from routine primary-care records. OBJECTIVES:identify risk factors in primary-care electronic healt...

    journal_title:Age and ageing

    pub_type: 杂志文章

    doi:10.1093/ageing/afaa006

    authors: Bowman K,Jones L,Masoli J,Mujica-Mota R,Strain D,Butchart J,Valderas JM,Fortinsky RH,Melzer D,Delgado J

    更新日期:2020-04-27 00:00:00

  • Polypharmacy including falls risk-increasing medications and subsequent falls in community-dwelling middle-aged and older adults.

    abstract:BACKGROUND:polypharmacy is an important risk factor for falls, but recent studies suggest only when including medications associated with increasing the risk of falls. DESIGN:a prospective, population-based cohort study. SUBJECTS:6,666 adults aged ≥50 years from The Irish Longitudinal study on Ageing. METHODS:partic...

    journal_title:Age and ageing

    pub_type: 杂志文章

    doi:10.1093/ageing/afu141

    authors: Richardson K,Bennett K,Kenny RA

    更新日期:2015-01-01 00:00:00

  • Peritonitis in geriatric inpatients.

    abstract::Of 212 cases of peritonitis found in a retrospective study of geriatric inpatients, the most common causes were mesenteric infarction, malignancy, intestinal obstruction, perforated peptic ulcer, cholecystitis, diverticulitis and perforation of the urinary bladder. The diagnostic accuracy was 47%. Abdominal pain had b...

    journal_title:Age and ageing

    pub_type: 杂志文章

    doi:10.1093/ageing/20.2.90

    authors: Wroblewski M,Mikulowski P

    更新日期:1991-03-01 00:00:00