Validated scoring system identifies low-risk syncope patients
This study validated the Canadian Syncope Risk Score for predicting 30-day serious outcomes in patients presenting to the ED within 24 hours of syncope.
PRACTICE CHANGER
Physicians should use the Canadian Syncope Risk Score (CSRS) to identify and send home very low– and low-risk patients from the emergency department (ED) after a syncopal episode.
STRENGTH OF RECOMMENDATION
A: Validated clinical decision rule based on a prospective cohort study1
Thiruganasambandamoorthy V, Sivilotti MLA, Le Sage N, et al. Multicenter emergency department validation of the Canadian Syncope Risk Score. JAMA Intern Med. 2020;180:737-744. doi:10.1001/jamainternmed.2020.0288
This scoring system was also only validated with adult patients presenting within 24 hours of their syncopal episode. It is unknown how it may predict the outcomes of patients who present > 24 hours after syncope.
CHALLENGES TO IMPLEMENTATION
Clinicians may not be awareof the CSRS scoring system
The main challenge to implementation is practitioner awareness of the CSRS scoring system and how to use it appropriately, as there are several different syncopal scoring systems that may already be in use. Additionally, depending on the electronic health record used, the CSRS scoring system may not be embedded. Using and documenting scores may also be a challenge.
ACKNOWLEDGEMENT
The PURLs Surveillance System was supported in part by Grant Number UL1RR024999 from the National Center for Research Resources, a Clinical Translational Science Award to the University of Chicago. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Center for Research Resources or the National Institutes of Health.
