A single emergency center study on the Canadian Syncope Risk Score applied to a patients visited with syncope in Korea

¹Department of Emergency Medicine, CHA Bundang Medical Center, CHA University, Seongnam, Korea
²Department of Emergency Medicine, CHA Gumi Medical Center, CHA University, Gumi, Korea
³Department of Emergency Medicine, School of Medicine, Kyungbook National University, Daegu, Korea
⁴Department of Emergency Medicine, Catholic University of Daegu School of Medicine, Daegu, Korea

Correspondence

Yong Seok Park ,Tel: 054-450-9997, Fax: 054-450-9886, Email: jisilpark@naver.com,

Received: June 29, 2017; Revised: July 3, 2017 Accepted: October 16, 2017. Published online: April 30, 2018.

ABSTRACT

Objective:
Syncope is mostly benign, but it can also be caused by a life-threatening situation. In Korea, no studies have investigated application of the Canadian Syncope Risk Score (CSRS) to patients with syncope; therefore, this study was started to evaluate the usefulness of CSRS.
Method:
A total of 222 patients who visited the emergency room with syncope for one year from January 2016 to December 2016 were enrolled in this study. Patients were divided into two groups, a serious adverse events (SAE) group and a non-serious adverse events group. The scores of the nine CSRS variables were added and the CSRS was then calculated after the addition.
Results:
The CSRS score for patients with SAE ranged from 0 to 8. The CSRS score was 18.6%, 31.7%, 55.6%, and 58.8% for 0, 1, 2, and 3, respectively. In the case of CSRS 0 and 1, 17 patients (81.0%) and 11 patients (84.6%) were non-cardiac. In the case of CSRS 2, 7 were non-cardiac (70.0%). In the case of CSRS 3, 6 cases (60.0%) were cardiogenic and 4 cases (40.0%) were non-cardiogenic. The area under the receiver operating characteristic curve of CSRS to predict SAE was 0.71. Setting the CSRS cutoff value to 0, we found that sensitivity and specificity of predicting SAE was 67.19% and 67.09%, respectively.
Conclusion:
CSRS may be difficult to predict for acute intracranial disease or acute hemorrhagic disease requiring transfusion; therefore, it is necessary to supplement it further.

Key words: Syncope; Risk factors; Emergency service; Hospitals