Safe to drive after syncope? New Canadian research sheds light

It may not be necessary to place driving restrictions on patients who visit the emergency department after a first episode of syncope, data from a new study suggests. Patients who visited the emergency department after syncope had a similar risk of getting into a motor vehicle crash as patients who visited the emergency department for another reason. Dr. John Staples from the University of British Columbia and colleagues analyzed data from 9, 223 patients who visited six Vancouver emergency departments for syncope or collapse between 2010 and 2015. These patients were age- and sex-matched with 34,366 patients who visited the emergency department for other reasons. All patients studied had a valid driver’s licence. Medical records were then linked to administrative health records, crash reports and driving history data from the Insurance Corporation of B.C., which insures all drivers in the province. Baseline data showed both groups of patients had a higher risk of getting into a motor vehicle accident than the general population before their visit to the emergency department. Yet after a visit to the emergency department, the two groups had a similar risk of a motor vehicle accident, at 9.2% in the syncope group and 10.1% in the control group. The risk of a crash was not significantly heightened in the first 30 days after the emergency department visit for syncope, compared to a visit for other conditions. “These findings suggest that more stringent driving restrictions after syncope may not be warranted,” the researchers wrote in their paper. The paper was published in a recent issue of JAMA Internal Medicine. Read: QUIZ: Test your knowledge on seniors’ fitness to drive The researchers note that drivers may have decided to drive less following their emergency department visit, or physicians may have restricted driving for patients who were likely to have a subsequent syncope episode. The findings contradict previous research which compared patients with the general population, or had no comparators, note Dr. Cary Gross and Mark Rosekind in an accompanying editorial. This study used a control group of other patients who had visited the emergency department, which the researchers state is “more highly relevant to clinicians” in the emergency department. The Canadian Council of Motor Transport Administrators has a document on determining fitness to drive, including information on various medications and conditions. Currently, there are no recommended restrictions on driving following a single episode of vasovagal syncope, unless the syncope occurred in a sitting position. After a second episode within a year, patients should stop driving for one week. For those with unexplained syncope, they should avoid driving for one week; and for three months after a recurrent episode. For those with untreated ventricular arrhythmias, driving should be suspended for up to six months. Read: Obstructive sleep apnea behind drivers falling asleep at the wheel

Safe to drive after syncope? New Canadian research sheds light

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