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Comment & Response
August 2016

Syncope While Driving in Denmark

Author Affiliations
  • 1Birmingham VA Medical Center, Birmingham, Alabama
  • 2University of Alabama at Birmingham (UAB) Medical Center, Birmingham, Alabama
JAMA Intern Med. 2016;176(8):1230. doi:10.1001/jamainternmed.2016.3723

To the Editor The recent study by Numé et al1 in a recent issue of JAMA Internal Medicine reports an association between prior hospitalization for syncope and increased risk of motor vehicle crashes, with subsequent recommendations for including syncope in the assessment of fitness to drive. This study differs significantly from previous studies in that the patients in this Danish nationwide cohort study were older (median age, 66 years), with a higher incidence of cardiovascular disease (34.8%).1 Thus, while the cause of syncope was not reported, this group possibly had syncope owing to another cause besides vasovagal syncope (VVS). In a study of highly symptomatic patients with VVS (mean [SD] age 38 [17] years), there was a low incidence of VVS while driving (2 of 174 cases), with a low estimated risk of serious harm or death (<0.0035% per person-year).2

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