Describe characteristics of patients diagnosed with syncope and migraine at University of Washington Medical System.  Analyze comorbidities of in this patient cohort.

Syncope has been one of many symptoms commonly found in migraine patients.  In a Dutch population-based study, prevalence of lifetime syncope was higher in migraine patients than in healthy adults (46% vs 31%), and studies have shown that patients with migraine have 1.9-2.7 times increased risk of syncope.  We investigated the burden of syncope in migraine patients and risk factors for both migraine and syncope within our University of Washington patient population.

The Leaf research database was used to obtain retrospective data for all patients with ICD-9 or ICD-10 code diagnoses for syncope (using ICD 9 – 780.2 and ICD 10 R55) and migraine (using ICD 9 346-346.93 and ICD 10 G43.909-911) at the University of Washington.  Demographics, employment and insurance are shown.  Sub-analysis for comorbidities was performed.

Total patient population with migraine was 67,849 out of a total population of 5,019,353.  Total number of patients with syncope diagnosis was 58,071.  9.08% of syncope patients also are diagnosed with migraine (n=5272), from this: chronic migraine (n=747) and episodic migraine (n=4839).  Syncope and tension-type headaches (n=1533).  Psychiatric comorbid conditions of patients with syncope and migraine included depressive disorders (n=1409, 26.7%), anxiety disorders (n=2571, 48.8%), and suicidal ideation (n=482, 9.14%).  Other comorbidities we looked at of syncope and migraine included diabetes (n=1,004, 18.9%), insomnia (n=1886, 35.8%), and obesity (n=1,263, 24%).

From our analysis we identified significant psychiatric comorbid burden for patients with syncope and migraine especially depressive disorders (n=1409, 26.7%), anxiety disorders (n=2571, 48.8%), and suicidal ideation (n=482, 9.14%). There needs to be increased awareness that patients presenting with syncope and migraine together have high likelihood of having anxiety and depression that need to be identified and managed.