R.E.B.E.L.EM - September 11, 2017 - By Swaminathan A
"Authors Conclusions:
“The Canadian Syncope Arrhythmia Risk Score can improve patient safety by identification of those at-risk for arrhythmias and aid in acute management decisions. Once validated, the score can identify low-risk patients who will require no further investigations.”
Our Conclusions:
This prospectively derived decision instrument may be helpful in stratifying syncope patients to high or low risk for dysrhythmia but requires external validation prior to consideration for implementation.
Potential to Impact Current Practice:
Because dysrhythmia is a common reason for admission to hospital and further workup of patients presenting with syncope, this decision tool has the potential to be used to support a decision of discharge and follow up and avoid low yield inpatient evaluations if externally validated.
Clinical Bottom Line:
The prospective derivation of this decision instrument is a positive step towards risk stratification of syncope patients for subsequent dysrhythmias. It is critical to remember that there are numerous other causes of syncope (ectopic pregnancy, PE, ACS, aortic dissection, GI bleeding etc) that should be considered in patients as well. Additionally, because the population in this study was relatively young and healthy, evaluation of a higher risk cohort would be useful in future studies."