Usefulness of syncope guidelines in risk stratification of syncope in emergency department

Background: Management of patients with syncope in the Emergency Department now focuses on identifying patients who will be at future risk of serious morbidity. Among the risk stratification scoring systems being used were the San Francisco Syncope Rule (SFSR) and Osservatorio Epidemiologico sulla S...

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Main Authors: Kamphee Sruamsiri, Boriboon Chenthanakij, Aphinant Tantiwut, Borwon Wittayachamnankul
Format: Journal
Published: 2018
Online Access:https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=84900804025&origin=inward
http://cmuir.cmu.ac.th/jspui/handle/6653943832/45532
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Institution: Chiang Mai University
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spelling th-cmuir.6653943832-455322018-01-24T06:11:51Z Usefulness of syncope guidelines in risk stratification of syncope in emergency department Kamphee Sruamsiri Boriboon Chenthanakij Aphinant Tantiwut Borwon Wittayachamnankul Background: Management of patients with syncope in the Emergency Department now focuses on identifying patients who will be at future risk of serious morbidity. Among the risk stratification scoring systems being used were the San Francisco Syncope Rule (SFSR) and Osservatorio Epidemiologico sulla Sincope nel Lazio (OESIL) score. Objective: To assess the accuracy of SFSR and OESIL score at predicting short-term serious outcome in Maharaj Nakorn Chiang Mai Hospital. Material and Method: In a prospective descriptive analysis study, adult patients presenting with syncope or near syncope between October 1, 2009 and April 24, 2010 were enrolled. All patients were followed-up at 7-day and 1-month. Statistical analysis included accuracy, sensitivity, specificity, predictive values, and likelihood ratios. Results: One hundred seventy eight patients were enrolled in the present study. Fifty-three patients had a short-term serious outcome on follow-up. SFSR had 74.7% accuracy, 90.6% sensitivity, 68% specificity, 54.5% PPV, 94.4% NPV, likelihood ratio positive (LR+) of 2.8, and likelihood ratio negative (LR-) of 0.1, whereas OESIL score had 80.9% accuracy, 79.4% sensitivity, 81.6% specificity, 64.6% PPV, 90.3% NPV, LR+ of 4.3, and LR- of 0.2. Conclusion: Both scores have good accuracy and sensitivity, but they should not be used as the only device in patient disposition. However, both scores showed a low false negative rate. Therefore, they may help in helping physician discharge low-risk patients. 2018-01-24T06:11:51Z 2018-01-24T06:11:51Z 2014-01-01 Journal 01252208 2-s2.0-84900804025 https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=84900804025&origin=inward http://cmuir.cmu.ac.th/jspui/handle/6653943832/45532
institution Chiang Mai University
building Chiang Mai University Library
country Thailand
collection CMU Intellectual Repository
description Background: Management of patients with syncope in the Emergency Department now focuses on identifying patients who will be at future risk of serious morbidity. Among the risk stratification scoring systems being used were the San Francisco Syncope Rule (SFSR) and Osservatorio Epidemiologico sulla Sincope nel Lazio (OESIL) score. Objective: To assess the accuracy of SFSR and OESIL score at predicting short-term serious outcome in Maharaj Nakorn Chiang Mai Hospital. Material and Method: In a prospective descriptive analysis study, adult patients presenting with syncope or near syncope between October 1, 2009 and April 24, 2010 were enrolled. All patients were followed-up at 7-day and 1-month. Statistical analysis included accuracy, sensitivity, specificity, predictive values, and likelihood ratios. Results: One hundred seventy eight patients were enrolled in the present study. Fifty-three patients had a short-term serious outcome on follow-up. SFSR had 74.7% accuracy, 90.6% sensitivity, 68% specificity, 54.5% PPV, 94.4% NPV, likelihood ratio positive (LR+) of 2.8, and likelihood ratio negative (LR-) of 0.1, whereas OESIL score had 80.9% accuracy, 79.4% sensitivity, 81.6% specificity, 64.6% PPV, 90.3% NPV, LR+ of 4.3, and LR- of 0.2. Conclusion: Both scores have good accuracy and sensitivity, but they should not be used as the only device in patient disposition. However, both scores showed a low false negative rate. Therefore, they may help in helping physician discharge low-risk patients.
format Journal
author Kamphee Sruamsiri
Boriboon Chenthanakij
Aphinant Tantiwut
Borwon Wittayachamnankul
spellingShingle Kamphee Sruamsiri
Boriboon Chenthanakij
Aphinant Tantiwut
Borwon Wittayachamnankul
Usefulness of syncope guidelines in risk stratification of syncope in emergency department
author_facet Kamphee Sruamsiri
Boriboon Chenthanakij
Aphinant Tantiwut
Borwon Wittayachamnankul
author_sort Kamphee Sruamsiri
title Usefulness of syncope guidelines in risk stratification of syncope in emergency department
title_short Usefulness of syncope guidelines in risk stratification of syncope in emergency department
title_full Usefulness of syncope guidelines in risk stratification of syncope in emergency department
title_fullStr Usefulness of syncope guidelines in risk stratification of syncope in emergency department
title_full_unstemmed Usefulness of syncope guidelines in risk stratification of syncope in emergency department
title_sort usefulness of syncope guidelines in risk stratification of syncope in emergency department
publishDate 2018
url https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=84900804025&origin=inward
http://cmuir.cmu.ac.th/jspui/handle/6653943832/45532
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