John A. Staples, MD, FRCPC, MPH Academic General Internist Vancouver General Hospital Clinical Assistant Professor at UBC

Syncope: Risk of Auto Accident After ER Visit for Fainting Interview with:

John A. Staples, MD, FRCPC, MPH Academic General Internist Vancouver General Hospital Clinical Assistant Professor at UBC

Dr. Staples

John A. Staples, MD, FRCPC, MPH
Academic General Internist
Vancouver General Hospital
Clinical Assistant Professor at UBC  What is the background for this study?   

Response: As a hospital-based general internist, I often see patients in the emergency department after an episode of syncope. Syncope is a medical term for suddenly losing consciousness (the public generally knows this as “fainting”). As you can imagine, fainting out of the blue can be very unnerving. Patients and clinicians worry that it may happen again and wonder whether it’s safe to drive. The first time I was asked this question, I remember scouring the research literature for an answer and not finding any robust evidence to guide my advice to patients.

Better post-syncope driving advice is needed because syncope results in 1.3 million emergency department visits in the United States every year. Driving restrictions after syncope might prevent patients from injuring themselves or others in a crash. But driving restrictions also adversely affect patients’ ability to work, socialize, and care for their family. We thought a study might help clinicians and patients make better decisions about driving after syncope.  What are the main findings?

Response: Our retrospective cohort study used linked health data and driving data to examine crash risks after syncope. We compared 9,223 patients who visited the emergency department for syncope with 34,366 age- and sex-matched patients who visited the emergency department in the same month for a condition other than syncope. In the year following the initial emergency department visit, we found that the risk of traffic crash after syncope is no different than the risk among typical emergency department patients.

Interestingly, both syncope patients and controls exhibited crash risks that were about 50% higher than those observed among the general population. What should readers take away from your report?

Response: Earlier studies implied that syncope doubles the risk of subsequent crash. Our findings suggest that we don’t need to impose additional road safety restrictions on drivers presenting to the emergency department with first-episode syncope.

It’s important that readers understand that some patients in our study were likely warned by the emergency physician not to drive. These warnings were almost certainly directed toward the individuals at highest risk of syncope recurrence. We think that these types of patients should continue to be warned not to drive. Our study makes the point that driving restrictions after syncope don’t need to be more stringent. What recommendations do you have for future research as a result of this work?

Response: We need to more accurately identify the individuals with syncope that are at the highest risk of crash. This would allow us to better target driving restrictions.

I have no disclosures. 


Staples JA, Erdelyi S, Merchant K, et al. Syncope and the Risk of Subsequent Motor Vehicle Crash: A Population-Based Retrospective Cohort Study. JAMA Intern Med. Published online August 01, 2022. doi:10.1001/jamainternmed.2022.2865

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Last Updated on August 3, 2022 by Marie Benz MD FAAD