Canadian Syncope Risk Score Identifies ED Monitoring Time Postsyncope

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The researchers found that 7.5% of patients suffered serious outcomes, and 3.7% of these patients were arrhythmic.
The researchers found that 7.5% of patients suffered serious outcomes, and 3.7% of these patients were arrhythmic.

HealthDay News — The risk for arrhythmic conditions can be identified quickly among patients with syncope presenting to the emergency department, according to a study published online Jan. 21 in Circulation.

Venkatesh Thiruganasambandamoorthy, M.B.B.S., from the University of Ottawa in Ontario, Canada, and colleagues conducted a prospective cohort study enrolling adults presenting to six emergency departments within 24 hours of syncope. A total of 5,581 patients were followed for 30 days for a primary outcome of serious arrhythmic conditions.

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The researchers found that 7.5 percent of patients suffered serious outcomes, and 3.7 percent of these patients were arrhythmic. Overall, 73.9, 19.0, and 7.1 percent were classified as low-, medium-, and high-risk, respectively, according to the Canadian Syncope Risk Score (CSRS). The CSRS accurately stratified patients as low-, medium-, and high-risk, with 0.4, 8.7, and 25.3 percent, respectively, suffering an arrhythmic outcome. In low-risk patients, half of arrhythmic outcomes were identified within two hours of emergency department arrival; for medium- and high-risk patients, half of arrhythmic outcomes were identified within six hours. After these cut points, the residual risk was 0.2, 5.0, and 18.1 percent for low-, medium-, and high-risk patients, respectively. Among medium- and high-risk patients, 91.7 percent of arrhythmic outcomes, including all ventricular arrhythmias, were identified within 15 days.

"Underlying arrhythmia is most often identified in the first two hours for CSRS low-risk patients, and in the first six hours for CSRS medium- and high-risk patients," the authors write.

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