Can I Send This Syncope Patient Home From the Emergency Department?

Tannenbaum, Lloyd; Keim, Samuel M.; April, Michael D.; Long, Brit; Koyfman, Alex; Mattu, Amal

doi:10.1016/j.jemermed.2021.07.060

Cited by 2 publications

(2 citation statements)

References 25 publications

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“…Although not a head-to-head comparison, one review indirectly compared the diagnostic accuracy of CSRS and FAINT studies. This review highlighted the diagnostic accuracy of the FAINT score is not better than CSRS, even when the FAINT score is compared to the results of the original study (10).…”

Section: Discussionmentioning

confidence: 99%

“…Considering that the 2-year mortality of patients with syncope, which constitutes 1% of emergency service admissions, is approximately 30%, the detection of underlying life-threatening pathologies constitutes the primary focus of emergency services (2,(5)(6)(7)(8). Although a serious underlying disease is detected only in 5-10% of these patients, more than half of them are hospitalized and this causes overuse of existing resources (8,10). Many syncope risk scoring systems have been developed, such as the Canadian Syncope Risk Score (CSRS) and the San Francisco Syncope Rule (SFSR), which aim to safely discharge low-risk patients with accurate risk strati cation and reduce unnecessary examinations and hospitalizations.…”

Section: Introductionmentioning

confidence: 99%

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Performance of FAINT score for predicting poor clinical outcome in elderly patients presenting with syncope

koçkara,

Aksel,

Delipoyraz

et al. 2023

Preprint

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Background and Objectives Our study aimed to investigate the diagnostic accuracy of the FAINT score in predicting 30-day all-cause death and serious cardiac outcomes in patients aged 60 years and older presenting with syncope. Methods Our study, which was designed as a single-center, prospective cohort study, included patients aged 60 years and older who presented to the emergency department with complaints of syncope or presyncope. The primary outcome of the study was defined as 30-day all-cause death or serious cardiac outcome (poor clinical outcome). physician gestalt. Results Of the 172 patients included in our study, 9 patients (5.2%) were in the poor clinical outcome group, while 163 (94.8%) patients were in the good clinical outcome group. The sensitivity of the FAINT score was 77.8%, and the specificity was 33.7%. The sensitivity and specificity of the Canadian Syncope Risk Score, which showed the best diagnostic test performance, were calculated as 88.9% and 35.6%, while the sensitivity and specificity of the San Francisco Syncope Rule were 66.7% and 49.1%. The clinician's gestalt had a sensitivity of 33.3% and specificity of 97.6%, showing the lowest performance of all scorings. Conclusion The FAINT score showed lower success compared to the diagnostic test performance measures reported in the original study. According to the results of our study, we think that none of the scorings performed adequately and that there is a need to develop clinical decision-making algorithms with higher diagnostic accuracy in the management of patients presenting with syncope.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Performance of FAINT score for predicting poor clinical outcome in elderly patients presenting with syncope

koçkara,

Aksel,

Delipoyraz

et al. 2023

Preprint

View full text Add to dashboard Cite

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A Metabolomic Approach to Unexplained Syncope

Longo,

Cicalini,

Pieragostino

et al. 2024

Biomedicines

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Background: This study aims to identify a metabolomic signature that facilitates the classification of syncope and the categorization of the unexplained syncope (US) to aid in its management. Methods: We compared a control group (CTRL, n = 10) with a transient loss of consciousness (TLC) group divided into the OH group (n = 23) for orthostatic syncope, the NMS group (n = 26) for neuromediated syncope, the CS group (n = 9) for cardiological syncope, and the US group (n = 27) for US defined as syncope without a precise categorization after first- and second-level diagnostic approaches. Results: The CTRL and the TLC groups significantly differed in metabolic profile. A new logistic regression model has been developed to predict how the US will be clustered. Using differences in lysophosphatidylcholine with 22 carbon atom (C22:0-LPC) levels, 96% of the US belongs to the NMS and 4% to the CS subgroup. Differences in glutamine and lysine (GLN/LYS) levels clustered 95% of the US in the NMS and 5% in the CS subgroup. Conclusions: We hypothesize a possible role of C22:0 LPC and GLN/LYS in re-classifying US and differentiating it from cardiological syncope.

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Can I Send This Syncope Patient Home From the Emergency Department?

Cited by 2 publications

References 25 publications

Performance of FAINT score for predicting poor clinical outcome in elderly patients presenting with syncope

Performance of FAINT score for predicting poor clinical outcome in elderly patients presenting with syncope

A Metabolomic Approach to Unexplained Syncope

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