Prognostic role of previous syncope spells in ED patients with syncope

Previous episodes, although frequent, don't correlate with adverse outcomes so don't help to identify high risk patients. Conversely, a first syncopal episode, especially in elderly patients, requires careful evaluation to rule out any underlying acute condition. Additionally, attention should be also paid to patients with previous episodes clustered in the last period or complicated by severe injuries, as they negatively impact quality of life.