Clinical factors associated with quality of life in patients with transient loss of consciousness

Introduction: Transient loss of consciousness (TLOC) is common and can be lethal. Although the patients with the most prevalent causes of TLOC have a benign prognosis, morbidity is considerable. Aim of this article, therefore, was to compare the generic quality of life (QoL) of patients presenting with TLOC with that of the general population, to compare the disease-specific QoL with that of an American referral sample, and to examine which sociodemographic and clinical factors are associated with QoL in these patients. Methods: This study was part of the fainting assessment study (FAST), which assessed diagnostic strategies for adult patients presenting with TLOC to the Academic Medical Center Amsterdam, between February 2000 and May 2002. The generic short form-36 (SF-36) health survey and the disease-specific syncope functional status questionnaire (SFSQ) were used to assess QoL. Results: Of 468 included patients, 82% completed the questionnaires. Patients with TLOC scored poorer on all scales of the SF-36 than the Dutch population, with effect sizes ranging from 0.43 to 1.11 (>0.5 = moderate effect; >0.8 = large effect). The SFSQ indicated mean impairment in 33% of the listed activities (such as driving). Female gender, higher level of comorbidity, shorter duration of complaints, having had more than one syncopal episode, and the presence of presyncopal episodes were associated with poorer QoL. Conclusion: TLOC seriously affects QoL, especially in patients with a recent onset of clinical symptoms and those suffering from both syncopal and presyncopal episodes.