San Francisco syncope rule

5 variables predict serious outcomes* in patients presenting with syncopal episode 1) abnormal electrocardiogram 2) shortness of breath 3) systolic blood pressure < 90 mm Hg 4) hematocrit < 30% 5) history of congestive heart failure Sensitivity 96% Specificity 62% Hospitalizing patients with at least 1 positive predictive variable would yield 45% hospitalization compared with 55% hospitalization which occurred without using rule. * serious outcome defined as death, myocardial infarction, cardiac arrhythmia, pulmonary embolism, stroke, subarachnoid hemorrhage, other significant hemorrhage, other condition likely to lead to return emergency department visit

References

- Journal Watch 24(6):50, 2004 - Quinn JV et al Derivation of the San Francisco Syncope Rule to predict patients with short-term serious outcomes. Ann Emerg Med 43:224, 2004 PMID: 14747812