Key result
Mild versus moderate autonomic dysfunction shows no clinical or prognostic differences in pediatric vasovagal syncope.
Why the study?
An adequate large-scale pediatric cohort based on nationwide administrative data is lacking in Korea, prompting an evaluation to differentiate VVS patients by autonomic dysfunction severity using CASS and compare clinical manifestations and prognosis.
Does the degree of autonomic dysfunction affect clinical manifestations, diagnostic test findings, or prognosis in pediatric patients with vasovagal syncope?
Observational (n=66)
No
Does the degree of autonomic dysfunction affect clinical manifestations, diagnostic test findings, or prognosis in pediatric patients with vasovagal syncope?
The severity of autonomic dysfunction (mild vs. moderate) does not significantly affect the clinical characteristics, diagnostic test findings, or prognosis of pediatric patients with vasovagal syncope.
Autonomic dysfunction severity does not stratify pediatric vasovagal syncope outcomes; hypothesis-generating and requires prospective validation.
BACKGROUND: An adequate large-scale pediatric cohort based on nationwide administrative data is lacking in Korea. PURPOSE: This study aimed to differentiate patients with VVS by autonomic dysfunction severity using the composite autonomic severity score (CASS) and compare the clinical manifestations and prognosis between patient subgroups. METHODS: We retrospectively reviewed the medical records of 66 VVS patients divided into 3 groups by CASS. To compare the differences between these groups, we analyzed VVS type, triggers, prodromal symptoms, management of syncope, and prognosis between patients with mild versus moderate autonomic dysfunction. RESULTS: Of our 66 patients with VVS, 41 had mild autonomic dysfunction (62.1%) and 25 had moderate autonomic dysfunction (37.9%). We found no significant intergroup differences in age, sex, inducible factor (P=0.172), prodromal symptoms, laboratory findings, head-up tilt test, type of syncope, or prognosis (P=0.154). CONCLUSION: We found no evidence that autonomic dysfunction degree is affected by VVS characteristics, test findings, parameters, or prognosis; therefore, no further evaluations are needed to classify autonomic dysfunction severity.
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Lee et al. (2021) conducted an observational in Vasovagal syncope (n=66). Mild autonomic dysfunction vs. Moderate autonomic dysfunction was evaluated on Prognosis (presence of symptoms during follow-up) (p=0.154). There were no significant differences in clinical manifestations, test findings, or prognosis between pediatric vasovagal syncope patients with mild versus moderate autonomic dysfunction.
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