OESIL Risk Score for a Patient with Syncope

 

Patient selection: syncope (transient loss of consciousness with an inability to maintain postural tone, followed by spontaneous recovery.

 

Exclusion: seizure disorder, presyncope, vertigo

 

Outcome: severe if death, need for major therapeutic procedure, or early readmission to the hospital

 

Parameters:

(1) abnormal ECG

(2) previous history of cardiovascular diseases (ischemic heart disease, valvular heart disease, other structural heart disease, congestive heart failure, peripheral arterial disease, stroke or TIA)

(3) prodromal symptoms

(4) age in years

 

Abnormal ECG - any of the following:

(1) atrial fibrillation or tachycardia

(2) sinus pause of >= 2 seconds

(3) sinus bradycardia with heart rate 35-45 beats per minute

(4) bundle branch block, second-degree Mobitz I atrioventricular block or other conduction disorder

(5) ECG changes of previous myocardial infarction or ventricular hypertrophy

(6) multiple premature beats

Parameter	Findings	Points
abnormal ECG	no	0
	yes	1
history of cardiovascular disease	no	0
	yes	1
prodromal symptoms	no	1
	yes	0
age in years	<= 65 years	0
	> 65 years	1

 

total score =

= SUM(points for all 4 parameters)

 

Interpretation:

• minimum score: 0

• maximum score: 4

• A score of 0 or 1 indicates a low risk episode.

• A score >= 2 indicates moderate to high risk, and the patient should be admitted to the hospital.

 

Score	1-Year All Cause Mortality
0	0%
1	0.8%
2	20%
3	35%
4	57%

 

Performance:

• The sensitivity was 88% and the specificity 59% in the study of Dipaola et al.

• The area under the ROC curve was 0.89 in the validation cohort.