1.The Practice of Dr. Jungblut, Frankfurt/Main, Germany
2.The Flight Medicine Clinic at Fassberg, German Armed Forces, Faßberg, Germany
3.The Department of Tropical Medicine at the Bernhard Nocht Institute, German Armed Forces Hospital of Hamburg, Hamburg, Germany
4.The Department of Microbiology, Virology and Hygiene, University Medicine Rostock, Rostock, Germany
*: frickmann@bni-hamburg.de
纸质出版:2016-03
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Syncope as a health risk for soldiers - influence of medical history and clinical findings on the sensitivity of head-up tilt table testing[J]. MMR, 2016,3(1):34-42.
Hans-Joachim Gilfrich, Lena Marie Heidelmann, Franziska Grube, et al. Syncope as a health risk for soldiers - influence of medical history and clinical findings on the sensitivity of head-up tilt table testing[J]. Military Medical Research, 2016, 3(1): 34-42.
Syncope as a health risk for soldiers - influence of medical history and clinical findings on the sensitivity of head-up tilt table testing[J]. MMR, 2016,3(1):34-42. DOI:
Hans-Joachim Gilfrich, Lena Marie Heidelmann, Franziska Grube, et al. Syncope as a health risk for soldiers - influence of medical history and clinical findings on the sensitivity of head-up tilt table testing[J]. Military Medical Research, 2016, 3(1): 34-42. DOI:
Background:
2
Syncope is a relevant health problem in military environments. Reliable diagnosis is challenging. Tilt table testing is an important tool for syncope diagnosis. The aim of this study was to determine whether signs such as prodromal symptoms
co-morbidity
frequency of syncopal events
body length
body mass index
and electrocardiography abnormalities can be used to predict the success of tilt table testing at diagnosing syncope.
Methods:
2
Data from 100 patients with histories of syncope or pre-syncope
who were diagnosed using head-up tilt table testing
were retrospectively analyzed in a cross-sectional analysis. The diagnostic procedure was based upon a modified version of the Westminster protocol without any pharmacological provocation.
Results:
2
Patients showing pathological reaction patterns during tilt table testing suffered from prodromal symptoms
such as dizziness and sweating
significantly more often. The patients reported more injuries resulting from syncopal events and more previous syncopal events
and the prevalence of co-morbidity was greater among patients presenting negative findings during tilt testing. An asthenic-leptosomal physique was not confirmed as a risk factor for syncopal events as is the case for idiopathic arterial hypotension. However
patients with pathological reaction patterns during tilt table testing were significantly taller. This finding was detected for both females and males. No significant predictors were found in the electrocardiogram patterns of patients showing syncope during tilt table testing.
Conclusions:
2
Frequency of prior syncope and prodromal symptoms
and increased body length with an otherwise good state of health influence the predictive value of tilt table testing for syncope diagnosis. In particular
if these factors are present
tilt table testing should be considered part of the diagnostic algorithm for soldiers with recurrent syncope.
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