Daniel Garcia Gomes1, Teresa Kus2, Roberto Tofani Sant'anna1, Gustavo Glotz de Lima1, Vidal Essebag2,3, Tiago L Luz Leiria4,5. 1. Post-Graduate Program in Health Sciences, Cardiology Institute of Rio Grande do Sul/Cardiology University Foundation, Porto Alegre, Brazil. 2. Hôpital du Sacré-Coeur de Montréal, Université de Montréal, Montreal, Québec, Canada. 3. McGill University Health Center Research Institute, Montreal, Quebec, Canada. 4. Post-Graduate Program in Health Sciences, Cardiology Institute of Rio Grande do Sul/Cardiology University Foundation, Porto Alegre, Brazil. drleiria@gmail.com. 5. Unidade de Pesquisa, Av. Princesa Isabel, 370, Santana Porto Alegre, RS, 90620-001, Brazil. drleiria@gmail.com.
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.
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.
Authors: Erik von Elm; Douglas G Altman; Matthias Egger; Stuart J Pocock; Peter C Gøtzsche; Jan P Vandenbroucke Journal: Lancet Date: 2007-10-20 Impact factor: 79.321
Authors: Benjamin C Sun; Carol M Mangione; Guy Merchant; Timothy Weiss; Gil Z Shlamovitz; Gelareh Zargaraff; Sharon Shiraga; Jerome R Hoffman; William R Mower Journal: Ann Emerg Med Date: 2007-01-08 Impact factor: 5.721
Authors: P Alboni; M Brignole; C Menozzi; A Raviele; A Del Rosso; M Dinelli; A Solano; N Bottoni Journal: J Am Coll Cardiol Date: 2001-06-01 Impact factor: 24.094
Authors: Shamai A Grossman; Christopher Fischer; Lewis A Lipsitz; Lawrence Mottley; Kenneth Sands; Scott Thompson; Peter Zimetbaum; Nathan I Shapiro Journal: J Emerg Med Date: 2007-07-05 Impact factor: 1.484
Authors: Monica Solbiati; Viviana Bozzano; Franca Barbic; Giovanni Casazza; Franca Dipaola; James V Quinn; Matthew J Reed; Robert S Sheldon; Win-Kuang Shen; Benjamin C Sun; Venkatesh Thiruganasambandamoorthy; Raffaello Furlan; Giorgio Costantino Journal: Intern Emerg Med Date: 2018-01-18 Impact factor: 3.397
Authors: Martin Duckheim; Katharina Klee; Nina Götz; Paul Helle; Patrick Groga-Bada; Lars Mizera; Meinrad Gawaz; Christine S Zuern; Christian Eick Journal: Medicine (Baltimore) Date: 2017-12 Impact factor: 1.817