The EGSYS and OESIL risk scores for classification of cardiac etiology of syncope: comparison, revaluation, and clinical implications.
OBJECTIVE
EGSYS-U, EGSYS-M, and OESIL risk scores for syncope evaluation are introduced, evaluated retrospectively, and their ability to classify cardiac syncopes is compared. The specificity and sensitivity of the scores were analyzed. Guidelines for the practical application of the scoring systems are provided to reduce unnecessary hospital admissions.


METHODS
Retrospectively, 153 patients with syncope admitted to the Faculty Hospital in Ostrava in the year 2008 were enrolled for scoring with the EGSYS and OESIL risk scores. The computed scores were assessed with respect to the diagnosed etiology of the syncope.


RESULTS
For each score system, the hypothesis that there is no difference in the score between the cardiac and the non-cardiac group was rejected (all p-values below 0.0001). Strong correlation between the three score systems was shown (Spearman correlation coefficient: r = 0.71 p < 0.0001 for EGSYS-U and OESIL, r = 0.88 p < 0.0001 for EGSYS-U and EGSYS-M, r = 0.60 p < 0.0001 for EGSYS-M and OESIL). Sensitivity and specificity of the scores were computed and compared.


CONCLUSIONS
All three score systems were found capable of classifying cardiac syncopes, reducing unnecessary hospital admissions and improving syncope risk evaluation. EGSYS-U was recommended for emergency syncope management because it was found to have both high sensitivity and high specificity.
Plasek
Jiri
J
Department of Internal Medicine, University Hospital, University of Ostrava, Czech Republic. jiri_plasek@centrum.cz
Doupal
Vlastimil
V
Fürstova
Jana
J
Martinek
Arnost
A
D006331:Heart Diseases / Q000150:complications*; D006801:Humans; D012680:Sensitivity and Specificity; D013575:Syncope / Q000145:classification / Q000175:diagnosis* / Q000209:etiology