Skip to main page content
Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Clinical Trial
. 1997 Apr;29(4):459-66.
doi: 10.1016/s0196-0644(97)70217-8.

Risk Stratification of Patients With Syncope

Affiliations
Clinical Trial

Risk Stratification of Patients With Syncope

T P Martin et al. Ann Emerg Med. .

Abstract

Study objective: To develop and validate a risk classification system for patients presenting to emergency departments with syncope.

Methods: Two prospective studies were carried out at a large urban teaching hospital ED. One cohort of 252 patients with syncope who reported to the ED was used to develop the risk classification system; a second cohort of 374 patients with syncope was used to validate the system. Data from the patient's history, physical examination and ED ECG were used to identify predictors of arrhythmias or mortality within the first year. Arrhythmias were detected by cardiac monitoring or electrophysiologic studies. Logistic regression and Cox proportional hazards models were used to identify the important risk factors for the classification system. Performance of the system was measured by comparing the proportion of patients with arrhythmias or death at various levels of the risk and receiver operating characteristic curves.

Results: Multivariate predictors of arrhythmia or 1-year mortality were an abnormal ED ECG (odds ratio [OR], 3.2; 95% confidence interval [CI], 1.6 to 6.4); history of ventricular arrhythmia (OR, 4.8; 95% CI, 1.7 to 13.9); history of congestive heart failure (OR, 3.2; 95% Cl, 1.3 to 8.1). Arrhythmias or death within 1 year occurred in 7.3% (derivation cohort) to 4.4% (validation cohort) of patients without any risk factors and in 80.4% (derivation) to 57.6% (validation) of patients with three or four risk factors.

Conclusion: Historical and ECG factors available at the time of presentation can be used to stratify risk of arrhythmias or mortality within 1 year in ED patients presenting with syncope.

Comment on

Similar articles

See all similar articles

Cited by 41 articles

  • Syncope in the Emergency Department.
    Sandhu RK, Sheldon RS. Sandhu RK, et al. Front Cardiovasc Med. 2019 Dec 3;6:180. doi: 10.3389/fcvm.2019.00180. eCollection 2019. Front Cardiovasc Med. 2019. PMID: 31850375 Free PMC article. Review.
  • Risk Stratification of Older Adults Who Present to the Emergency Department With Syncope: The FAINT Score.
    Probst MA, Gibson T, Weiss RE, Yagapen AN, Malveau SE, Adler DH, Bastani A, Baugh CW, Caterino JM, Clark CL, Diercks DB, Hollander JE, Nicks BA, Nishijima DK, Shah MN, Stiffler KA, Storrow AB, Wilber ST, Sun BC. Probst MA, et al. Ann Emerg Med. 2020 Feb;75(2):147-158. doi: 10.1016/j.annemergmed.2019.08.429. Epub 2019 Oct 23. Ann Emerg Med. 2020. PMID: 31668571 Clinical Trial.
  • Updated Geriatric Cardiology Guidelines of the Brazilian Society of Cardiology - 2019.
    Feitosa-Filho GS, Peixoto JM, Pinheiro JES, Afiune Neto A, Albuquerque ALT, Cattani ÁC, Nussbacher A, Camarano AA, Sichinels AH, Sousa ACS, de Alencar Filho AC, Gravina CF, Sobral Filho DC, Pitthan E, Costa EFA, Duarte EDR, Freitas EV, Moriguchi EH, Mesquita ET, Fernandes F, Feitosa GS, Pierre H, Pereira Filho I, Helber I, Borges JL, Garcia JMA, Souza JAG, Zanon JCDC, Alves JC, Mohallem KL, Chaves LMSM, Moura LAZ, Silva MCAD, Toledo MAV, Assunção MELSM, Wajngarten M, Gonçalves MJO, Lopes NHM, Rodrigues NL, Toscano PRP, Rousseff P, Maia RAR, Franken RA, Miranda RD, Gamarski R, Rosa RF, Santos SCM, Galera SC, Grespan SMDS, Silva TCRD, Esteves WAM. Feitosa-Filho GS, et al. Arq Bras Cardiol. 2019 Jun 6;112(5):649-705. doi: 10.5935/abc.20190086. Arq Bras Cardiol. 2019. PMID: 31188969 Free PMC article. No abstract available.
  • Predictors of Short-Term Outcomes after Syncope: A Systematic Review and Meta-Analysis.
    Gibson TA, Weiss RE, Sun BC. Gibson TA, et al. West J Emerg Med. 2018 May;19(3):517-523. doi: 10.5811/westjem.2018.2.37100. Epub 2018 Mar 13. West J Emerg Med. 2018. PMID: 29760850 Free PMC article. Review.
  • Syncope and bundle branch block : Diagnostic approach.
    Moya A, Rivas-Gandara N, Perez-Rodón J, Franciso-Pascual J, Santos-Ortega A, Fumero P, Roca-Luque I. Moya A, et al. Herzschrittmacherther Elektrophysiol. 2018 Jun;29(2):161-165. doi: 10.1007/s00399-018-0560-4. Epub 2018 Apr 25. Herzschrittmacherther Elektrophysiol. 2018. PMID: 29696347 Review. English.
See all "Cited by" articles

MeSH terms

Feedback