The predictive value of urine specific gravity in the diagnosis of vasovagal syncope in children and adolescents

Abstract

Background Vasovagal syncope (VVS) is a kind of common neurally mediated syncope in children and adolescents. Decreased blood volume is one of the pathogenesis of VVS. The diagnosis of VVS is mainly based on head-up tilt test (HUTT), but some complications may easily occur when HUTT induces syncope. To find a simple and safe VVS diagnosis method can improve the VVS diagnosis efficiency. Aims of the study This was a prospective study. The study will explore the predictive value of urine specific gravity (USG) in the diagnosis of VVS in children and adolescents. Patients and methods Ninety-seven cases (43 males and 54 females, aged 4 to 16 years old, with an average age of 10.91 ± 2.18 years old) hospitalized due to unexplained premonitory syncope or syncope and diagnosed with VVS through HUTT from September 2014 to September 2018 were selected as VVS group. During the same period, 91 cases of children and adolescents, including 45 males and 46 females, aged from 5 to 15 years old, who underwent a healthy examination were matched as a control (control group). USG was measured in both groups. Results The USG of VVS group was significantly lower than that of the control group (P < 0.01), and USG of females was lower than that of males in VVS group (P = 0.045). The sensitivity and specificity of USG in predicting VVS were evaluated by ROC curve. The area under the ROC curve was 0.751, standard error was 0.035, and 95% CI (0.683, 0.819) suggested that USG was of moderate predictive value in the diagnosis of VVS. As cut-off value of USG was 1.0185, the sensitivity and specificity and diagnostic coincidence rate of VVS were 74.39, 66.04 and 69.68%, respectively. Conclusion There are less USG in children and adolescents with VVS, especially lower USG in females. Therefore, USG has predictive value in the diagnosis of VVS in children and adolescents.

Differentiation of epilepsy and psychogenic nonepileptic events based on body fluid characteristics

“…Urine‐specific gravity and hydration status were reported to be predictors of early neurological deterioration in acute ischemic stroke 39,40 . The level of urine‐specific gravity also showed a decreasing trend in children and adolescents with vasovagal syncope, especially in females 41 . Differences in urine pH and conductivity could not be explained clearly.…”

“…39,40 The level of urine-specific gravity also showed a decreasing trend in children and adolescents with vasovagal syncope, especially in females. 41 Differences in urine pH and conductivity could not be explained clearly. The results should be treated with caution considering that the volume and composition of urine are also determined by physical exertion, environmental conditions, and water, salt, and protein intake.…”

Application of mind map can promote the health education effect of children with vasovagal syncope

“…In addition to seriously affecting the physical and mental health and quality of life of the children, the parents are also under great psychological pressure. Therefore, paying attention to the psychological feelings and service requirements of children with VVS and their parents, especially the health education of children and their parents, and improving their compliance, are the key links to promoting the rehabilitation of children ( 20 , 21 ).…”

Development of prognostic nomogram model to predict syncope recurrence in children with vasovagal syncope

“…An increase in USG indicates low water intake or excessive water loss. Prior studies have shown that USG had a specific predictive value in diagnosing VVS in children and adolescents ( 25 ). However, there is a paucity of data on its role in predicting syncope of presyncope recurrence.…”