Comparison of existing syncope rules and newly proposed anatolian syncope rule to predict short-term serious outcomes after syncope in the Turkish population

International Journal of Emergency Medicine, 05/25/2012

Kayayurt K et al. – The newly proposed Anatolian Syncope Rule (ASR) appears to be highly sensitive for identifying patients at risk for short–term serious outcomes, with scores at least as good as those provided by existing diagnostic rules, and it is easier to perform at the bedside within the Turkish population. If prospectively validated, it may offer a tool to aid physicians' decision–making.

Methods

  • This prospective, cohort study was conducted at the emergency department of a tertiary care centre.
  • Between December 1 2009 and December 31 2010, the authors prospectively collected data on patients of ages 18 and over who presented to the emergency department with syncope.
  • They enrolled 231 patients to the study.
  • A univariate analysis found 23 variables that predicted syncope with adverse events.

Results

  • Dyspnoea, orthostatic hypotension, precipitating cause of syncope, age over 58years, congestive heart failure, and electrocardiogram abnormality (termed DO-PACE) were found to predict short-term serious outcomes by logistic regression analysis and these were used to compose the ASR.
  • The sensitivity of ASR, OESIL, EGSYS and SFSR for mortality were 100% (0.66 to 1.00); 90% (0.54 to 0.99), 80% (0.44 to 0.97) and 100% (0.66 to 1.00), respectively.
  • The specificity of ASR, OESIL, EGSYS and SFSR for mortality were 78% (0.72 to 0.83); 76% (0.70 to 0.82); 80% (0.74 to 0.85) and 70% (0.63 to 0.76).
  • The sensitivity of ASR, OESIL, EGSYS and SFSR for any adverse event were 97% (0.85 to 1.00); 70% (0.52 to 0.82); 56% (0.40 to 0.72) and 87% (0.72 to 0.95).
  • The specificity of ASR, OESIL, EGSYS and SFSR for any adverse event were 72% (0.64 to 0.78); 82% (0.76 to 0.87); 84% (0.78 to 0.89); 78% (0.71 to 0.83), respectively.

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