title: Prognosis of patients with syncope seen in the emergency room department: an evaluation of four different risk scores recommended by the European Society of Cardiology guidelines.
abstract: OBJECTIVE
  To apply, analyze, and evaluate the four syncope risk scores recommended by the 2009 European guidelines and the different parameters that they use to predict death, syncope recurrence, and hospital readmission in the population seen in the emergency room department (ERD) for syncope.
  
  
  RESULTS
  A total of 323 patients aged older than 14 years [mean age 59 (32-75) years] and seen in ERD for syncope over a 2-month period were included in the study; 50.7% were women. Patients were evaluated using the four risk scores and were followed up for at least 2 years. In all, 275 patients (85.2%) were discharged directly from ERD after evaluation. During 28±5 months of follow-up, 8% died, 18.3% presented a further syncopal episode, and 18.6% were readmitted to hospital. Only two of the four risk scores were useful in risk discrimination, but no statistically significant differences were detected between predicted risk and observed risk. Multivariate analysis indicated relationships between age and death, a history of cardiovascular disease and syncope recurrence, and between presyncopal palpitations and hospital readmission.
  
  
  CONCLUSIONS
  Although a large number of events occur after syncope, the risk scores recommended by guidelines overestimate risk, but there were no statistically significant differences between observed and predicted risk.
authors.affiliation: aCardiology and Emergency Department, Virgen del Rocío University Hospital, University of Seville, Seville bDepartment of Medicine, University Cadiz, Cádiz, Spain.
authors.forename: Gonzalo
authors.initials: G
authors.lastname: Barón-Esquivias
authors.forename: Agustín
authors.initials: A
authors.lastname: Fernández-Cisnal
authors.forename: Álvaro
authors.initials: Á
authors.lastname: Arce-León
authors.forename: Rocio
authors.initials: R
authors.lastname: Toro
authors.forename: Eva
authors.initials: E
authors.lastname: Cantero-Pérez
authors.forename: Juan
authors.initials: J
authors.lastname: Parejo-Matos
authors.forename: Nieves
authors.initials: N
authors.lastname: Romero-Rodriguez
authors.forename: Emilio
authors.initials: E
authors.lastname: Montero
authors.forename: Angel
authors.initials: A
authors.lastname: Martinez
mesh_terms: D000328:Adult; D000368:Aged; D002309:Cardiology / Q000592:standards; D015331:Cohort Studies; D004562:Electrocardiography / Q000379:methods*; D004636:Emergency Service, Hospital; D017052:Hospital Mortality; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D017410:Practice Guidelines as Topic; D011379:Prognosis; D011446:Prospective Studies; D012008:Recurrence; D018570:Risk Assessment; D012720:Severity of Illness Index; D012955:Societies, Medical; D013030:Spain; D016019:Survival Analysis; D013575:Syncope / Q000175:diagnosis / Q000401:mortality / Q000628:therapy*