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Syncope Risk Score for Patient in ED

Purpose: To identify a patient in the Emergency Department (ED) with syncope who may be at increased risk for a serious outcome.

Description

Martin et al identified factors for serious outcomes in a patient with syncope presenting to an Emergency Department. These can help identify a patient who may benefit from more aggressive management. The authors are from the University of Pittsburgh.


High risk outcomes within 1 year:

(1) cardiac arrhythmias (using a broad definition)

(2) death

 

Parameters:

(1) age

(2) ECG in the ED

(3) history of ventricular arrhythmias

(4) history of congestive heart failure (CHF)

 

Parameter

Finding

Points

age in years

<= 45 years

0

 

> 45 years

1

ECG in the ED

normal or nonspecific ST and T wave changes

0

 

abnormal

1

history of ventricular arrhythmias

absent

0

 

present

1

history of CHF

absent

0

 

present

1

 

where:

• Abnormal ECG changes include: atrial fibrillation, atrial flutter, multifocal atrial tachycardia, junctional or paced rhythms, ventricular tachycardia, premature ventricular contractions, bundle branch block, intraventricular conduction delay, AV heart block.

 

total score =

= SUM(points for all 4 parameters)

 

Interpretation:

• minimum score: 0

• maximum score: 4

• The higher the score the greater the risk for a high risk outcome within 1 year.

 

Total Score

Risk

0

4-7%

1

15%

2

30-40%

3 or 4

60-80%

 


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Specialty

Objective

ICD-10