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Comparison of syncope risk scores in predicting the prognosis of patients presenting to the emergency department with syncope

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Abstract

Background

Various scores have been derived for the assessment of syncope patients in the emergency department (ED).

Aim

We aimed to compare the effectiveness of Canadian Syncope Risk Scores (CSRS), San Francisco Syncope Rules (SFSR), and Osservatorio Epidemiologico sulla Sincope nel Lazio (OESIL) risk scores in predicting the risk of major adverse cardiac events (MACE) and mortality among syncope patients within 30 days of the initial ED visit.

Methods

We performed a prospective, observational case series study of adults (≥ 18 years) with unexplained syncope/near-syncope who presented to ED. Demographic characteristics of the patients and clinical and laboratory data were recorded in the standard data collection form of the study. Our primary outcome was a 30-day mortality.

Results

A total of 421 patients (mean age 50.9 ± 20.8, 51.5% male) were enrolled. The rate of MACE development in the 30-day follow-up of the patients was 12.8% (n = 54). While 20.2% (n = 85) of the patients were hospitalized, two of the patients died in the emergency room and the 30-day mortality was 5.5% (n = 23). CSRS was found to have the highest predictive power of mortality (AUC: 0.869, 95% CI 0.799–0.939, p < 0.001). If the cut-off value of CSRS was 0.5, the sensitivity was found to be 82.6% and the specificity was 81.9%. Also CSRS (OR: 1.402, 95% CI: 1.053–1.867, p = 0.021) was found to be an independent predictor of the 30-day mortality.

Conclusion

The CSRS may be used as a safety risk score for a 30-day risk of MACE and mortality after discharge from the emergency department.

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Authors and Affiliations

  1. Clinic of Emergency Medicine, Health Sciences University Adana City Training and Research Hospital, Adana, Yuregir, 01370, Turkey

    Cagdas INCE, Muge GULEN, Selen ACEHAN, Sarper SEVDIMBAS & Salim SATAR

  2. Department of Emergency Medicine, Kahramanmaras Necip Fazıl City Hospital, Kahramanmaras, Turkey

    Muhammet BALCIK

  3. Department of Emergency Medicine, Hatay City Training and Research Hospital, Hatay, Turkey

    Ali YUKSEK

Authors
  1. Cagdas INCE
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  2. Muge GULEN
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Contributions

Cagdas Ince: conceptualization, data curation, formal analysis, investigation, methodology, validation, writing—review and editing. Muge Gulen: conceptualization, data curation, formal analysis, investigation, methodology, validation, writing—review and editing. Selen Acehan: conceptualization, data curation, formal analysis, resources, software, visualization, writing—review and editing. Sarper Sevdimbas: conceptualization, data curation, formal analysis, writing original draft, writing—review and editing. Muhammet Balcik: conceptualization, data curation, formal analysis, writing original draft, writing—review and editing. Ali Yuksek: conceptualization, data curation, formal analysis, funding acquisition, project administration, supervision, writing original draft, writing—review and editing. Salim Satar: conceptualization, data curation, formal analysis, funding acquisition, project administration, supervision, writing original draft, writing—review and editing. All authors reviewed the drafts and approved the final version of the article for submission.

Corresponding author

Correspondence to Muge GULEN.

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Before starting the study, an ethical approval was obtained from the Ethics Committee of the Faculty of Medicine, dated 2 April 2021 and numbered 45.

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The authors declare no competing interests.

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INCE, C., GULEN, M., ACEHAN, S. et al. Comparison of syncope risk scores in predicting the prognosis of patients presenting to the emergency department with syncope. Ir J Med Sci 192, 2727–2734 (2023). https://doi.org/10.1007/s11845-023-03395-6

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  • DOI: https://doi.org/10.1007/s11845-023-03395-6

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