title: Simple risk stratification score for prognosis of syncope.
abstract: OBJECTIVE
  The aim of this study is to describe a new simple score to predict the occurrence of severe adverse events in patients admitted for syncope to a tertiary cardiology referral center.
  
  
  METHODS
  Three hundred ninety-three subjects with emergency department visits for syncope were identified and followed prospectively. The primary endpoint was death or unplanned hospital admission after the syncopal episode. The score consisted of sum of the following: previous syncope (2 points), an abnormal electrocardiogram (3 points), and history of heart disease (4 points). The accuracy of our score was compared to other scores available in the literature.
  
  
  RESULTS
  Of the 393 subjects, 87 were diagnosed with syncope secondary to structural or electrical heart disease and 306 with noncardiac syncope. The primary endpoint occurred in 202 cases, including death occurring in 25 patients during the 12-month follow-up. The 30-day event rate for the primary endpoint was 26.5 %. The c-statistic for the new score was 0.76 (95 % CI 0.71-0.80) similar to other scores when applied to our sample. Patients with a score of 3 out of 9 had a hazard ratio of 3.46 (95 % CI 1.22-6.11) for death during the follow-up.
  
  
  CONCLUSIONS
  In the study population, the new syncope score detected patients with an increased risk of death after discharge from a syncopal event. Our score predicted adverse events comparably to other scores reported in the literature. It has the advantage of being simple and easily obtained from the history and an inexpensive noninvasive test-the ECG.
authors.affiliation: Post-Graduate Program in Health Sciences, Cardiology Institute of Rio Grande do Sul/Cardiology University Foundation, Porto Alegre, Brazil.
authors.forename: Daniel Garcia
authors.initials: DG
authors.lastname: Gomes
authors.affiliation: Hôpital du Sacré-Coeur de Montréal, Université de Montréal, Montreal, Québec, Canada.
authors.forename: Teresa
authors.initials: T
authors.lastname: Kus
authors.affiliation: Post-Graduate Program in Health Sciences, Cardiology Institute of Rio Grande do Sul/Cardiology University Foundation, Porto Alegre, Brazil.
authors.forename: Roberto Tofani
authors.initials: RT
authors.lastname: Sant'anna
authors.affiliation: Post-Graduate Program in Health Sciences, Cardiology Institute of Rio Grande do Sul/Cardiology University Foundation, Porto Alegre, Brazil.
authors.forename: Gustavo Glotz
authors.initials: GG
authors.lastname: de Lima
authors.affiliation: Hôpital du Sacré-Coeur de Montréal, Université de Montréal, Montreal, Québec, Canada.|McGill University Health Center Research Institute, Montreal, Quebec, Canada.
authors.forename: Vidal
authors.initials: V
authors.lastname: Essebag
authors.affiliation: Post-Graduate Program in Health Sciences, Cardiology Institute of Rio Grande do Sul/Cardiology University Foundation, Porto Alegre, Brazil. drleiria@gmail.com.|Unidade de Pesquisa, Av. Princesa Isabel, 370, Santana Porto Alegre, RS, 90620-001, Brazil. drleiria@gmail.com.
authors.forename: Tiago L Luz
authors.identifier: http://orcid.org/0000-0002-3905-102X
authors.initials: TL
authors.lastname: Leiria
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001938:Brazil / Q000453:epidemiology; D015897:Comorbidity; D016757:Death, Sudden, Cardiac / Q000453:epidemiology*; D004562:Electrocardiography / Q000379:methods* / Q000706:statistics & numerical data; D005260:Female; D006331:Heart Diseases / Q000401:mortality*; D006801:Humans; D015994:Incidence; D008297:Male; D008487:Medical History Taking / Q000379:methods; D016016:Proportional Hazards Models; D015203:Reproducibility of Results; D012189:Retrospective Studies; D018570:Risk Assessment / Q000379:methods; D012680:Sensitivity and Specificity; D015996:Survival Rate; D013575:Syncope / Q000175:diagnosis* / Q000401:mortality*
keywords: Death; Hospitalization; Risk score; Syncope