Clinical predictors of cardiac syncope at initial evaluation in patients referred urgently to a general hospital: the EGSYS score
| Autor: | A. Del Rosso, T. De Santo, Franco Giada, Carlo Menozzi, N.R Petix, Michele Brignole, Roberto Maggi, Andrea Ungar |
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| Rok vydání: | 2008 |
| Předmět: |
Male
medicine.medical_specialty Heart Diseases Hospitals General Sensitivity and Specificity Severity of Illness Index Syncope Cohort Studies Internal medicine Epidemiology Severity of illness Palpitations medicine Humans Prospective Studies Prospective cohort study Referral and Consultation biology business.industry Syncope (genus) Emergency department Middle Aged biology.organism_classification Prognosis Hospitalization Cohort Physical therapy Female medicine.symptom Triage Cardiology and Cardiovascular Medicine business Emergency Service Hospital Cohort study |
| Zdroj: | Heart (British Cardiac Society). 94(12) |
| ISSN: | 1468-201X |
| Popis: | Objective: To develop, in patients referred for syncope to an emergency department (ED), a diagnostic score to identify those patients likely to have a cardiac cause. Design: Prospective cohort study. Setting: ED of 14 general hospitals. Patients: 516 consecutive patients with unexplained syncope. Interventions: Subjects underwent a diagnostic evaluation on adherence to Guidelines of the European Society of Cardiology. The clinical features of syncope were analysed using a standard 52-item form. In a validation cohort of 260 patients the predictive value of symptoms/signs was evaluated, a point score was developed and then validated in a cohort of 256 other patients. Main outcome measurements: Diagnosis of cardiac syncope, mortality. Results: Abnormal ECG and/or heart disease, palpitations before syncope, syncope during effort or in supine position, absence of autonomic prodromes and absence of predisposing and/or precipitating factors were found to be predictors of cardiac syncope. To each variable a score from +4 to –1 was assigned to the magnitude of regression coefficient. A score ⩾3 identified cardiac syncope with a sensitivity of 95%/92% and a specificity of 61%/69% in the derivation and validation cohorts, respectively. During follow-up (mean (SD) 614 (73) days) patients with score ⩾3 had a higher total mortality than patients with a score Conclusions: A simple score derived from clinical history can be usefully employed for the triage and management of patients with syncope in an ED. |
| Databáze: | OpenAIRE |
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