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Canadian Syncope Risk Score

Indications: - identification of patients with syncope who can be safely discharged after 2-6 hours of emergency department monitoring [1] Procedure: - predisposition to vasovagal syncope - heart disease - systolic BP in the emergency department < 90 or > 180 mm Hg - serum troponin level > 99th percentile - abnormal QRS axis (< -30 or > 100 degrees) - QRS duration > 130 ms - QTc interval > 480 ms - emergency department diagnosis of cardiac syncope - emergency department diagnosis of vasovagal syncope Notes: - internationally validated [4] - identifies patients at low risk for poor outcomes [4]

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References

  1. Thiruganasambandamoorthy V, Kwong K, Wells GA et al Development of the Canadian Syncope Risk Score to predict serious adverse events after emergency department assessment of syncope. CMAJ. 2016 Sep 6;188(12):E289-98. PMID: 27378464 Free PMC Article
  2. Thiruganasambandamoorthy V et al. Duration of electrocardiographic monitoring of emergency department patients with syncope. Circulation 2019 Jan 21; PMID: 30661373 https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.118.036088
  3. Thiruganasambandamoorthy V et al. Multicenter emergency department validation of the Canadian Syncope Risk Score. JAMA Intern Med 2020 Mar 23; PMID: 32202605 https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2763181
  4. Zimmerman T et al. International validation of the Canadian Syncope Risk Score: A cohort study. Ann Intern Med 2022 Apr 26; [e-pub]. PMID: 35467933 https://www.acpjournals.org/doi/10.7326/M21-2313