CanadiEM - April 20, 2020 - By Ramzy M
"Clinical Question:
Is the CSRS a valid clinical tool in predicting 30-day serious outcomes not evident during the index ED evaluation of syncope patients?
Author’s Conclusions:
The CSRS was successfully validated and its use is recommended to guide ED management of patients when serious causes are not identified during index ED evaluation. Very-low-risk and low-risk patients can generally be discharged, while brief hospitalization can be considered for high-risk patients. We believe CSRS implementation has the potential to improve patient safety and health care efficiency.
Our Conclusion:
In patient’s presenting to the ED with syncope, the CSRS appears to be a validated and reliable tool in determining the risk of serious outcomes in lower risk patients. Patients who are very low and low risk should still have close outpatient follow-up and given strict return precautions. A lower threshold for admission is warranted when determining the need for hospitalization of high and very high-risk patients. As well any other risk stratification score or clinical decision tool, clinical judgement, patient presentation and shared decision making should be incorporated prior to determining dispositions"