Syncope and Motor Vehicle Crash Risk

Abstract

IMPORTANCE Syncope may have serious consequences for traffic safety. Current clinical guideline recommendations on driving following syncope are primarily based on expert consensus. OBJECTIVE To identify whether there is excess risk of motor vehicle crashes among patients with syncope compared with the general population.

2017 ACC/AHA/HRS Guideline for the Evaluation and Management of Patients With Syncope: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Rhythm Society

“…The main concern is the risk of causing injury or death to the driver or others as a result of recurrent syncope. 691 Factors to consider in assessing the risk of syncope while driving are summarized in a formula developed by the Canadian Cardiovascular Society 25 years ago 692 that estimates the risk that a driver will suddenly become incapacitated. The acceptable level of risk then becomes a societal decision.…”

Prognostic significance of noncardiac syncope in the general population: A systematic review and meta‐analysis

“…However, if the required methods for any very specific diagnosis, such as pulmonary embolism, are not applied, or, in the scenario of paroxysmal disorders such as atrioventricular block, the true etiology of syncope associated with potential increased mortality may easily be missed. Second, the nonspecific diagnosis of syncope may herald higher risk of vehicle accidents, and also a history of vasovagal syncope may indicate a higher likelihood of coronary events later in life, although the pathophysiological mechanisms are not well understood. Third, syncope due to autonomic dysfunction and OH, which may have been unrecognized during the primary assessment of syncope, confers a higher risk of death, as shown in previous studies .…”

Fitness to Drive in Cardiovascular Disease

“…A defensive driving style should always be recommended. According to a recent Danish study, it may be assumed that the accident risk of individuals with syncope is double that of the general population for at least the 2 years following hospital admission for syncope (24). Table 3 shows the current BAST guidelines on fitness to drive of patients with syncope.…”