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Simple risk stratification score for prognosis of syncope

  • Published:
Journal of Interventional Cardiac Electrophysiology Aims and scope Submit manuscript

Abstract

Purpose

The aim of this study is to describe a new simple score to predict the occurrence of severe adverse events in patients admitted for syncope to a tertiary cardiology referral center.

Methods

Three hundred ninety-three subjects with emergency department visits for syncope were identified and followed prospectively. The primary endpoint was death or unplanned hospital admission after the syncopal episode. The score consisted of sum of the following: previous syncope (2 points), an abnormal electrocardiogram (3 points), and history of heart disease (4 points). The accuracy of our score was compared to other scores available in the literature.

Results

Of the 393 subjects, 87 were diagnosed with syncope secondary to structural or electrical heart disease and 306 with noncardiac syncope. The primary endpoint occurred in 202 cases, including death occurring in 25 patients during the 12-month follow-up. The 30-day event rate for the primary endpoint was 26.5 %. The c-statistic for the new score was 0.76 (95 % CI 0.71–0.80) similar to other scores when applied to our sample. Patients with a score of 3 out of 9 had a hazard ratio of 3.46 (95 % CI 1.22–6.11) for death during the follow-up.

Conclusions

In the study population, the new syncope score detected patients with an increased risk of death after discharge from a syncopal event. Our score predicted adverse events comparably to other scores reported in the literature. It has the advantage of being simple and easily obtained from the history and an inexpensive noninvasive test—the ECG.

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Abbreviations

AV:

Atrioventricular

Bpm:

Beats per minute

CAD:

Coronary artery disease

CI:

Confidence interval

COPD:

Chronic obstructive pulmonary disease

ECG:

Electrocardiogram

Hb:

Hemoglobin

HR:

Hazard ratio

ICD:

International Classification of Diseases

LBBB:

Left bundle branch block

OR:

Odds ratio

RBBB:

Right bundle branch block

Sat:

Oxygen saturation

SAH:

Systemic arterial hypertension

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Author information

Authors and Affiliations

  1. Post-Graduate Program in Health Sciences, Cardiology Institute of Rio Grande do Sul/Cardiology University Foundation, Porto Alegre, Brazil

    Daniel Garcia Gomes, Roberto Tofani Sant’anna, Gustavo Glotz de Lima & Tiago L. Luz Leiria

  2. Hôpital du Sacré-Coeur de Montréal, Université de Montréal, Montreal, Québec, Canada

    Teresa Kus & Vidal Essebag

  3. McGill University Health Center Research Institute, Montreal, Quebec, Canada

    Vidal Essebag

  4. Unidade de Pesquisa, Av. Princesa Isabel, 370, Santana Porto Alegre, RS, 90620-001, Brazil

    Tiago L. Luz Leiria

Authors
  1. Daniel Garcia Gomes
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  2. Teresa Kus
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  3. Roberto Tofani Sant’anna
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  4. Gustavo Glotz de Lima
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  5. Vidal Essebag
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  6. Tiago L. Luz Leiria
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Corresponding author

Correspondence to Tiago L. Luz Leiria.

Ethics declarations

The institutional research ethics committee in compliance with the Declaration of Helsinki approved the study.

Conflict of interest

The authors declare that they have no conflict of interest.

Funding

Dr. Essebag is the recipient of a Clinician Scientist award from the Canadian Institutes of Health Research (CIHR).

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Gomes, D.G., Kus, T., Sant’anna, R.T. et al. Simple risk stratification score for prognosis of syncope. J Interv Card Electrophysiol 47, 153–161 (2016). https://doi.org/10.1007/s10840-016-0165-y

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  • DOI: https://doi.org/10.1007/s10840-016-0165-y

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