# Prevalence of and Variables Associated with Syncope-Related Injuries and Fractures in Germany: A Cross-Sectional Study in General Practices

## TL;DR

This study finds that syncope-related injuries are common in Germany, especially among older adults and those with osteoporosis.

## Contribution

The study provides new insights into the prevalence and risk factors for syncope-related injuries in a large German outpatient population.

## Key findings

- Syncope-related injuries affect 10.4% of patients, increasing with age.
- Female sex and osteoporosis are significant risk factors for injuries and fractures.
- Older adults over 80 years have the highest injury rate at 15.0%.

## Abstract

Background: There is a lack of studies investigating the prevalence of syncope-related injuries in a large representative cohort. The aim of this cross-sectional study is to investigate the prevalence of, and variables associated with syncope-related injuries and fractures in a large outpatient population in Germany. Methods: The present study used data from the Disease Analyzer database (IQVIA) and included adults with first-time diagnoses of syncope in 1 of 1284 general practices in Germany between 2005 and 2022 (index date). The prevalence of injuries and separate fractures documented on the index date was examined, and the association of demographic and clinical variables with the risk of syncope-related injuries and fractures was studied using multivariable logistic regression. Results: A total of 143,226 patients (mean age: 57.1 years, 56.9% female) were included in this study. The proportion of injuries was 10.4% and increased from 6.4% in the age group 18–30 to 15.0% in the age group >80 years. Female sex was associated with a slightly higher risk of injury (OR: 1.09; 95% CI: 1.05–1.13) and fractures (OR: 1.17; 95% CI: 1.07–1.28). Osteoporosis was associated with a higher risk of injury (OR: 1.25; 95% CI: 1.16–1.34) and fracture (OR: 1.53; 95% CI: 1.33–1.76), while obesity was only associated with a slightly increased risk of injury. Conclusions: Syncope-related injuries are common among syncope patients. Factors associated with a higher risk of syncope-related injuries, such as female sex, older age, and osteoporosis, can be incorporated into an effective risk stratification and help to improve the outcome of syncope patients.