Key result
An orthostatic intolerance symptom score of 5.5 predicted postural tachycardia syndrome with 69.7% sensitivity and 72.0% specificity, and a score of 2.5 predicted vasovagal syncope.
Why the study?
The study was conducted to develop an orthostatic intolerance symptom scoring system to assess orthostatic intolerance and compare the symptom score among different head-up tilt test responses.
Does a new orthostatic intolerance symptom score predict head-up tilt test responses in children and adolescents?
Cross-Sectional (n=272)
Does a new orthostatic intolerance symptom score predict head-up tilt test responses in children and adolescents?
p-value: p=<.01
A newly developed symptom score can serve as a preliminary assessment instrument to predict head-up tilt test outcomes in children and adolescents with orthostatic intolerance.
May support preliminary symptom scoring in pediatric orthostatic intolerance; hypothesis-generating and requires prospective validation.
Objective: To develop an orthostatic intolerance symptom scoring system to assess orthostatic intolerance and then to compare the symptom score among different head-up tilt test responses. Methods: 272 subjects (5-18 years) presenting with orthostatic intolerance symptoms finished questionnaire and head-up tilt test. According to head-up tilt test hemodynamic responses, the subjects were divided into head-up tilt test negative, vasovagal syncope, and postural tachycardia syndrome groups. Results: We built up a symptom score according to the frequency of dizziness, headache, blurred vision, palpitations, chest discomfort, gastrointestinal symptoms, profuse perspiration, and syncope. The median score in postural tachycardia syndrome subjects was highest. A score of 2.5 for predicting vasovagal syncope yielded a sensitivity of 75.0% and specificity of 50.3%, a score of 5.5 for predicting postural tachycardia syndrome yielded a sensitivity of 69.7% and specificity of 72.0%. Furthermore, the median score in postural tachycardia syndrome subjects was significantly higher than that in head-up tilt test negative subjects with heart rate increment of 30-39 beats/min ( P < .01). Conclusions: This suggests that the symptom score has some predictive value in head-up tilt test results, which can be served as a preliminary assessment instrument.
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Cai et al. (2020) conducted a cross-sectional in Orthostatic intolerance (n=272). Orthostatic intolerance symptom score vs. Head-up tilt test responses was evaluated on Predictive value for vasovagal syncope and postural tachycardia syndrome (p=<.01). An orthostatic intolerance symptom score of 5.5 predicted postural tachycardia syndrome with 69.7% sensitivity and 72.0% specificity, and a score of 2.5 predicted vasovagal syncope.