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 Ageingjournal_title
Age and ageingauthors
Kumar NP,Thomas A,Mudd P,Morris RO,Masud Tdoi
10.1093/ageing/afg114subject
Has Abstractpub_date
2003-11-01 00:00:00pages
666-9issue
6eissn
0002-0729issn
1468-2834journal_volume
32pub_type
杂志文章相关文献
AGE AND AGEING文献大全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
更新日期:2014-09-01 00:00:00
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
更新日期:2002-11-01 00:00:00
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
更新日期:2019-09-01 00:00:00
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
更新日期:2000-03-01 00:00:00
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
更新日期:1994-09-01 00:00:00
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
更新日期:2018-05-01 00:00:00
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
更新日期:2005-11-01 00:00:00
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
更新日期:2013-11-01 00:00:00
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
更新日期:2014-11-01 00:00:00
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
更新日期:1990-11-01 00:00:00
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
更新日期:2014-07-01 00:00:00
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
更新日期:2009-05-01 00:00:00
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:
更新日期:1996-03-01 00:00:00
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
更新日期:2010-07-01 00:00:00
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
更新日期:1977-02-01 00:00:00
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
更新日期:1997-07-01 00:00:00
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
更新日期:1980-11-01 00:00:00
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
更新日期:1989-01-01 00:00:00
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
更新日期:1985-07-01 00:00:00
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
更新日期:2012-01-01 00:00:00
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
更新日期:2013-07-01 00:00:00
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
更新日期:1989-03-01 00:00:00
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
更新日期:2012-11-01 00:00:00
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
更新日期:2015-03-01 00:00:00
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
更新日期:2017-09-01 00:00:00
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
更新日期:2013-03-01 00:00:00
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
更新日期:2019-03-01 00:00:00
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
更新日期:2020-04-27 00:00:00
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
更新日期:2015-01-01 00:00:00
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
更新日期:1991-03-01 00:00:00