12-Lead ECG
Level |
Direction |
Primary Outcome |
Patient/Process |
Setting |
Reference |
I
|
Supportive (Green)
|
Serious adverse outcome at 30 days.
|
Patient
|
|
Gibson TA, Weiss RE, Sun BC. Predictors of Short-Term Outcomes after Syncope: A Systematic Review and Meta-Analysis. The western journal of emergency medicine 2018; 19(3):517-23. Medline
|
II
|
Supportive (Green)
|
Risk classification
|
Process
|
ED-MD
|
Colivicchi F., Ammirati F., Melina D., et al. Development and prospective validation of a risk stratification system for patients with syncope in the emergency department: The OESIL risk score. Eur Heart J 2003; 24(9):811-9. Medline
|
II
|
Supportive (Green)
|
Serious Adverse Events
|
Patient
|
|
Cook OG., Mukarram MA., Rahman OM., Kim SM., Arcot K., Thavorn K., et al. Reasons for Hospitalization Among Emergency Department Patients With Syncope. Academic emergency medicine : official journal of the Society for Academic Emergency Medicine 2016;23(11):1210-7. Medline
|
II
|
Supportive (Green)
|
30 day mortality
|
Patient
|
PH-Paramedic
|
Sato N, Minami Y, Ako J, Maeda A, Akashi Y, Ikari Y, et al. Clinical significance of prehospital 12-lead electrocardiography in patients with ST-segment elevation myocardial infarction presenting with syncope: from a multicenter observational registry (K-ACTIVE study). Heart Vessels 2021. Medline
|
III
|
Supportive (Green)
|
Factors associated with Mortality, Hospitalization, Intervention
|
Patient
|
ED-MD
|
D'Ascenzo F., Biondi-Zoccai G., Reed MJ., et al. Incidence, etiology and predictors of adverse outcomes in 43,315 patients presenting to the emergency department with syncope: An international meta-analysis. Int J Cardiol 2013; 167(1):57-62. Medline
|
III
|
Supportive (Green)
|
Syncope management
|
Process
|
ED-MD
|
Elesber AA., Decker WW., Smars PA., Hodge DO., Shen WK., American College of Emergency Physicians. Impact of the application of the american college of emergency physicians recommendations for the admission of patients with syncope on a retrospectively studied population presenting to the emergency department. Am Heart J 2005; 149(5):826-31. Medline
|
III
|
Supportive (Green)
|
Prevalence of acute cardiac ischemia
|
Process
|
ED-MD
|
Georgeson S., Linzer M., Griffith JL., Weld L., Selker HP. Acute cardiac ischemia in patients with syncope: Importance of the initial electrocardiogram. J Gen Intern Med 1992; 7(4):379-86. Medline
|
III
|
Supportive (Green)
|
prediction of Hyperkalaemia
|
Process
|
PH-Paramedic
|
Taxel S, Holtz M. Mysterious Weakness: Life-threatening condition can be managed in the field. JEMS 2017; 42(4):18-21. Medline
|
III
|
Neutral (Yellow)
|
Mortality
|
Process
|
ED-MD
|
Perez-Rodon J., Martinez-Alday J., Baron-Esquivias G., et al. Prognostic value of the electrocardiogram in patients with syncope: Data from the group for syncope study in the emergency room (GESINUR). Heart Rhythm 2014; 11(11):2035-44. Medline
|
Clinical Decision Making Rule
Level |
Direction |
Primary Outcome |
Patient/Process |
Setting |
Reference |
II
|
Supportive (Green)
|
Risk classification
|
Process
|
ED-MD
|
Colivicchi F., Ammirati F., Melina D., et al. Development and prospective validation of a risk stratification system for patients with syncope in the emergency department: The OESIL risk score. Eur Heart J 2003; 24(9):811-9. Medline
|
II
|
Supportive (Green)
|
30-day mortality
|
Process
|
ED-MD
|
Ince C, Gulen M, Acehan S, et al. Comparison of syncope risk scores in predicting the prognosis of patients presenting to the emergency department with syncope. Ir J Med Sci 2023; 192(6):2727-34. Medline
|
II
|
Supportive (Green)
|
Adverse event post discharge
|
Patient
|
ED-MD
|
Muhtaseb O, EA A, SA G. A Tale of Two Cities: Applying the Boston Syncope Criteria to Jerusalem. Isr Med Assoc J 2021; 23(7):420–5. Medline
|
II
|
Supportive (Green)
|
30-day outcome; risk stratification tool accuracy
|
Patient
|
ED-MD
|
Sweanor RAL, Redelmeier RJ, Simel DL , Albassam OT, Shadowitz S , Etchells EE. Multivariable risk scores for predicting short-term outcomes for emergency department patients with unexplained syncope: A systematic review. Acad Emerg Med 2021; 28(5):502–10. Medline
|
II
|
Neutral (Yellow)
|
Death within 30 days, Serious outcomes
|
Patient
|
ED-MD
|
Costantino G., Casazza G., Reed M., et al. Syncope risk stratification tools vs clinical judgment: An individual patient data meta-analysis. Am J Med 2014; 127(11):1126.e13-25. Medline
|
II
|
Neutral (Yellow)
|
MACE and Death at 2 years
|
Patient
|
ED-MD
|
du Fay de Lavallaz J, Badertscher P, Nestelberger T, Isenrich R, Miró Ò, Salgado E, et al. Prospective validation of prognostic and diagnostic syncope scores in the emergency department. Int J Cardiol 2018; 269:114-21. Medline
|
II
|
Neutral (Yellow)
|
30-day prediction of serious adverse event(s) post syncopy
|
Process
|
ED-MD
|
Grant L, Joo P, Nemnom MJ, Thiruganasambandamoorthy V. Machine learning versus traditional methods for the development of risk stratification scores: a case study using original Canadian Syncope Risk Score data. Intern Emerg Med 2022; 17(4):1145–53. Medline
|
II
|
Neutral (Yellow)
|
Additional valuation of a syncopy prognosis score.
|
Process
|
ED-MD
|
Moussa BS, Ali MA, Ali AAE, Abou Zeid AESM. Assessment of Canadian Syncope Risk Score in the prediction of outcomes of patients with syncope at the Emergency Department of Suez Canal University: STROBE compliant. Med 2022; 101(25):e29287. Medline
|
II
|
Neutral (Yellow)
|
Sensitivity and Specificity
|
Process
|
ED-MD
|
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(4):362-373. Medline
|
II
|
Neutral (Yellow)
|
Serious adverse event within 30 days
|
Patient
|
|
Thiruganasambandamoorthy V., Kwong K., Wells GA., Sivilotti ML., Mukarram M., Rowe BH., et al. Development of the Canadian Syncope Risk Score to predict serious adverse events after emergency department assessment of syncope. CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne 2016;188(12):E289-98. Medline
|
III
|
Supportive (Green)
|
Composite of mortality or arrhythmia
|
Patient
|
|
Thiruganasambandamoorthy V., Stiell IG., Sivilotti MLA., Rowe BH., Mukarram M., Arcot K., et al. Predicting Short-term Risk of Arrhythmia among Patients With Syncope: The Canadian Syncope Arrhythmia Risk Score. Academic emergency medicine : official journal of the Society for Academic Emergency Medicine 2017;24(11):1315-26. Medline
|
III
|
Neutral (Yellow)
|
Ability of CSRS to discriminate between cardiac and non-cardiac syncope
|
Process
|
ED-MD
|
Safari S, Khasraghi ZS, Chegeni MA, Ghabousian A, Amini A. The ability of Canadian Syncope risk score in differentiating cardiogenic and non-cardiogenic syncope; a cross-sectional study. Am J Emerg Med 2021; 50:675–8. Medline
|