Development of the Canadian Syncope Risk Score to predict serious adverse events after emergency department assessment of syncope

CMAJ

Volumn 188, Issue 12, 2016, Pages E289-E298

  Thiruganasambandamoorthy, Venkatesh ^a,b   Kwong, Kenneth ^a,b   Wells, George A ^a   Sivilotti, Marco L A ^c   Mukarram, Muhammad ^b   Rowe, Brian H ^d   Lang, Eddy ^e   Perry, Jeffrey J ^a,b   Sheldon, Robert ^f   Stiell, Ian G ^a,b   Taljaard, Monica ^a,b  

^a UNIVERSITY OF OTTAWA   (Canada)

^b OTTAWA HOSPITAL RESEARCH INSTITUTE   (Canada)

^c QUEEN S UNIVERSITY   (Canada)

^d UNIVERSITY OF ALBERTA   (Canada)

^e UNIVERSITY OF CALGARY   (Canada)

^f UNIVERSITY OF CALGARY   (Canada)

Author keywords

[No Author keywords available]

Indexed keywords

TROPONIN;

ADOLESCENT; ADULT; ARTICLE; BLEEDING; CANADIAN SYNCOPE RISK SCORE; CLINICAL DECISION SUPPORT SYSTEM; COHORT ANALYSIS; DEATH; DISEASE PREDISPOSITION; EMERGENCY WARD; FAINTNESS; FEMALE; HEART ARRHYTHMIA; HEART INFARCTION; HUMAN; LUNG EMBOLISM; MAJOR CLINICAL STUDY; MALE; PATIENT ASSESSMENT; PROSPECTIVE STUDY; QRS INTERVAL; QTC INTERVAL; RISK ASSESSMENT; SCORING SYSTEM; SENSITIVITY ANALYSIS; SYSTOLIC BLOOD PRESSURE; AGED; ARRHYTHMIAS, CARDIAC; CANADA; CLINICAL TRIAL; COMPLICATION; ELECTROCARDIOGRAPHY; GASTROINTESTINAL HEMORRHAGE; HOSPITAL DISCHARGE; HOSPITAL EMERGENCY SERVICE; MIDDLE AGED; MULTICENTER STUDY; MULTIVARIATE ANALYSIS; MYOCARDIAL INFARCTION; PROGNOSIS; PULMONARY EMBOLISM; RISK FACTOR; STATISTICAL MODEL; SYNCOPE; VERY ELDERLY; YOUNG ADULT;

ADOLESCENT; ADULT; AGED; AGED, 80 AND OVER; ARRHYTHMIAS, CARDIAC; CANADA; ELECTROCARDIOGRAPHY; EMERGENCY SERVICE, HOSPITAL; FEMALE; GASTROINTESTINAL HEMORRHAGE; HUMANS; LOGISTIC MODELS; MALE; MIDDLE AGED; MULTIVARIATE ANALYSIS; MYOCARDIAL INFARCTION; PATIENT DISCHARGE; PROGNOSIS; PROSPECTIVE STUDIES; PULMONARY EMBOLISM; RISK ASSESSMENT; RISK FACTORS; SYNCOPE; YOUNG ADULT;

EID: 84987834813     PISSN: 08203946     EISSN: 14882329     Source Type: Journal    
DOI: 10.1503/cmaj.151469     Document Type: Article

References (32)

1. Blanc JJ, L'Her C, Touiza A, et al. Prospective evaluation and outcome of patients admitted for syncope over a 1 year period. Eur Heart J 2002;23:815-20.
2. Sun BC, Emond JA, Camargo CA Jr. Characteristics and admission patterns of patients presenting with syncope to US emergency departments, 1992-2000. Acad Emerg Med 2004;11:1029-34.
3. Ganzeboom KS, Mairuhu G, Reitsma JB, et al. Lifetime cumulative incidence of syncope in the general population: a study of 549 Dutch subjects aged 35-60 years. J Cardiovasc Electrophysiol 2006;17:1172-6.
4. Moya A, Sutton R, Ammirati F, et al. Guidelines for the diagnosis and management of syncope (version 2009). Eur Heart J 2009;30:2631-71.
5. Kapoor WN. Evaluation and outcome of patients with syncope. Medicine 1990;69:160-75.
6. Quinn J, McDermott D, Stiell I, et al. Prospective validation of the San Francisco syncope rule to predict patients with serious outcomes. Ann Emerg Med 2006;47:448-54.
7. Thiruganasambandamoorthy V, Hess EP, Alreesi A, et al. External validation of the San Francisco syncope rule in the Canadian setting. Ann Emerg Med 2010;55:464-72.
8. Grossman SA, Fischer C, Lipsitz LA, et al. Predicting adverse outcomes in syncope. J Emerg Med 2007;33:233-9.
9. Reed MJ, Newby DE, Coull AJ, et al. The ROSE (risk stratification of syncope in the emergency department) study. J Am Coll Cardiol 2010;55:713-21.
10. Pires LA, Ganji JR, Jarandila R, et al. Diagnostic patterns and temporal trends in the evaluation of adult patients hospitalized with syncope. Arch Intern Med 2001;161:1889-95.
11. Thiruganasambandamoorthy V, Taljaard M, Stiell IG, et al. Emergency department management of syncope: need for standardization and improved risk stratification. Intern Emerg Med 2015;10:619-27.
12. Serrano LA, Hess EP, Bellolio MF, et al. Accuracy and quality of clinical decision rules for syncope in the emergency department: a systematic review and meta-analysis. Ann Emerg Med 2010;56:362-373.e1.
13. Quinn JV, Stiell IG, McDermott DA, et al. Derivation of the San Francisco syncope rule to predict patients with short-term serious outcomes. Ann Emerg Med 2004;43:224-32.
14. Costantino G, Perego F, Dipaola F, et al. Short- and long-term prognosis of syncope, risk factors, and role of hospital admission: results from the STePS (Short-Term Prognosis of Syncope) study. J Am Coll Cardiol 2008;51:276-83.
15. Sun BC, Thiruganasambandamoorthy V, Cruz JD. Consortium to Standardize ED Syncope Risk Stratification Reporting. Standardized reporting guidelines for emergency department syncope risk-stratification research. Acad Emerg Med 2012;19:694-702.
16. Thiruganasambandamoorthy V, Kwong K, Stiell IG, et al. Short-term risk of arrhythmias among emergency department syncope patients with non-sinus rhythm. Int J Cardiol 2015;189:12-4.
17. Sheldon RS, Morillo CA, Krahn AD, et al. Standardized approaches to the investigation of syncope: Canadian Cardiovascular Society position paper. Can J Cardiol 2011;27:246-53.
18. Thiruganasambandamoorthy V, Wells GA, Hess EP, et al. Derivation of a risk scale and quantification of risk factors for serious adverse events in adult emergency department syncope patients. CJEM 2014;16:120-30.
19. Thiruganasambandamoorthy V, Stiell IG, Sivilotti ML, et al. Risk stratification of adult emergency department syncope patients to predict short-term serious outcomes after discharge (RiSEDS) study. BMC Emerg Med 2014;14:8.
20. Sun BC, Costantino G, Barbic F, et al. Priorities for emergency department syncope research. Ann Emerg Med 2014;64:649-55.e2.
21. Steyerberg EW. Clinical prediction models: a practical approach to development, validation and updating. New York: Springer; 2009.
22. Little RJ, Rubin DB. Statistical analysis with missing data. 2nd ed. New York: John Wiley and Sons; 2002.
23. Efron B. Estimating the error rate of a prediction rule: improvement on cross-validation. J Am Stat Assoc 1983;78:316-31.
24. Le Gal G, Righini M, Roy PM, et al. Prediction of pulmonary embolism in the emergency department: the revised Geneva score. Ann Intern Med 2006;144:165-71.
25. Scheaffer RL, Mendenhall W, Ott L. Elementary survey sampling. 2nd ed. Pacific Grove (CA): Duxbury Press; 1979.
26. Kayayurt K, Akoglu H, Limon O, et al. Comparison of existing syncope rules and newly proposed Anatolian syncope rule to predict short-term serious outcomes after syncope in the Turkish population. Int J Emerg Med 2012;5:17.
27. Reed MJ, Newby DE, Coull AJ, et al. The Risk stratification Of Syncope in the Emergency department (ROSE) pilot study: a comparison of existing syncope guidelines. Emerg Med J 2007;24:270-5.
28. Sun BC, Derose SF, Liang LJ, et al. Predictors of 30-day serious events in older patients with syncope. Ann Emerg Med 2009;54:788.e1-5.
29. Del Rosso A, Ungar A, Maggi R, et al. Clinical predictors of cardiac syncope at initial evaluation in patients referred urgently to a general hospital: the EGSYS score. Heart 2008;94:1620-6.
30. Wells P, Anderson D. The diagnosis and treatment of venous thromboembolism [abstract]. Hematology Am Soc Hematol Educ Program 2013;2013:457-63.
31. Stiell IG, Wells GA. Methodologic standards for the development of clinical decision rules in emergency medicine. Ann Emerg Med 1999;33:437-47.
32. Collins GS, Reitsma JB, Altman DG, et al. Transparent reporting of a multivariable prediction model for individual prognosis or diagnosis (TRIPOD): the TRIPOD statement. Ann Intern Med 2015;162:55-63.