An international validation study found that the Canadian Syncope Risk Score (CSRS) showed good performance in the identification of patients at low risk for serious outcomes and, therefore, could potentially be discharge from the emergency department (ED). While the CSRS was also found to be superior to the Osservatorio Epidemiologico sulla Sincope nel Lazio (OESIL) risk score, keppra vs. levetiracetam side effects its clinical utility remains uncertain without further research. The findings are published in Annals of Internal Medicine.
Syncope is often benign, but some causes can be life threatening. The lack of accurate risk assessment for syncope leads to hospitalization in up to 80% of patients, with associated medical costs exceeding $2.4 billion annually. Several risk scores have been developed to assist emergency department staff triage patients, but none have been widely used in clinical practice.
The CSRS was developed as a decision tool to be used after emergency department assessment to identify patients who are at low risk for serious outcomes after 30 days. Initial validation of the CSRS demonstrated high prognostic accuracy, but other validation studies showed only moderate performance. The CSRS has not yet been compared to a validated syncope risk score, and the performance and utility outside of Canada remains unknown. It is also unknown whether the CSRS allows for the prediction of serious outcomes beyond 30 days or how well the CSRS predicts a composite of only serious clinical outcomes rather than the previously used composite that also included procedural interventions.
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