Syncope While Driving and the Risk of a Subsequent Motor Vehicle Crash - 18/01/24
, Shannon Erdelyi, MSc c, Ketki Merchant, MSc, MBBS a, Candace Yip, BSc a, Mayesha Khan, MA a, Donald A. Redelmeier, MD d, e, Herbert Chan, PhD c, Jeffrey R. Brubacher, MD b, cAbstract |
Study objective |
Syncope that occurs while driving can result in a motor vehicle crash. Whether individuals with a prior syncope-related crash exhibit an exceptional risk of subsequent crash remains uncertain.
Methods |
We performed a population-based retrospective observational study of patients diagnosed with ‘syncope and collapse’ at any of 6 emergency departments in British Columbia, Canada (2010 to 2015). Data were obtained from chart abstraction, administrative health records, insurance claims and police crash reports. We compared crash-free survival among individuals with crash-associated syncope (a crash and an emergency visit for syncope on the same date) to that among controls with syncope alone (no crash on date of emergency visit for syncope).
Results |
In the year following their index emergency visit, 13 of 63 drivers with crash-associated syncope and 852 of 9,160 controls with syncope alone experienced a subsequent crash as a driver (crash risk 21% versus 9%). After accounting for censoring and potential confounders, crash-associated syncope was not associated with a significant increase in the risk of subsequent crash (adjusted hazard ratio [aHR] 1.38, 95% confidence interval [CI] 0.78 to 2.47). Individuals with crash-associated syncope were 31-fold more likely to have physician driving advice documented during their index visit (prevalence ratio 31.0, 95% CI, 21.3 to 45.1). In the subgroup without documented driving advice, crash-associated syncope was associated with a significant increase in subsequent crash risk (aHR 1.88, 95% CI 1.06 to 3.36).
Conclusions |
Crash risk after crash-associated syncope appears similar to crash risk after syncope alone.
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| Please see page 148 for the Editor’s Capsule Summary of this article. |
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| Supervising editor: Ambrose H. Wong, MD, MSEd. Specific detailed information about possible conflict of interest for individual editors is available at editors. |
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| Author contributions: JAS and SE were responsible for study concept. JAS, SE, DAR, HC and JRB contributed to study design. JAS, SE, HC, and JRB were responsible for acquisition of administrative data. KM, CY, and JAS were responsible for medical record abstraction. SE had full access to all study data and was responsible for the integrity of the data and the accuracy of the data analysis. JAS was responsible for drafting the manuscript. All authors were responsible for critical revision of the manuscript. JAS takes responsibility for the paper as a whole. |
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| Data sharing statement: Access to data provided by the Data Stewards is subject to approval but can be requested for research projects through the Data Stewards or their designated service providers. |
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| Authorship: All authors attest to meeting the four ICMJE.org authorship criteria: (1) Substantial contributions to the conception or design of the work; or the acquisition, analysis, or interpretation of data for the work; AND (2) Drafting the work or revising it critically for important intellectual content; AND (3) Final approval of the version to be published; AND (4) Agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. |
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| Funding and support: By Annals’ policy, all authors are required to disclose any and all commercial, financial, and other relationships in any way related to the subject of this article as per ICMJE conflict of interest guidelines (see www.icmje.org/). This study was supported by the Canadian Institutes of Health Research (grant numbers PJT-148849). JAS was supported by a Mentored Clinician Scientist Award from the Vancouver Coastal Health Research Institute and a Health Professional-Investigator Award from Michael Smith Health Research BC. JRB is supported by Michael Smith Health Research BC and the British Columbia Emergency Medicine Network. Funding organizations were not involved in the design and conduct of the study; collection, management, analysis and interpretation of the data; or preparation, review and approval of this manuscript. The authors have declared that no competing interests exist. |
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Vol 83 - N° 2
P. 147-157 - février 2024 Retour au numéro
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